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Full text of "Ernst Mueller Collection 1911-"

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■olJer 1 



Joseph Müllar 



\ 



^eb. 30 Mai 1862 zu Mansbach 
^est. 2I.K0V. 1925 zu Schmalkulden 

Todes Urkunde 



II ame 

T^olf Müller Schuiimacher ,g8st . in einem Alter von 63 Jahren 10 M naten 

zu Mansbach am c2»März lo75 

Heirats Urkunde 



Trauungs 

Jahr Monat Tag 
1842 April 28 



K arjie , S t and . Aiter 

der neuen Eheleute 



^v-i-iX^ -'ni 



Wolf Müller, / Wittwer,\A/ar mit Galle? gebr •Imssbaum \ 

(hier verheiratet. / 

Est er Spier 22 Jare alt, ledig - ^. SO.G-^^M ^^ Q^t^W 



^ ^^mm mm*iK mf* ^n m 9m' ^ *m ^ ^ ^ »^ wy ^^acöag ' 



Vor-u.Zanaae , Stand der beiderseitigen Eltern der 

Sheleute 



"Leiser Müller war Lehrer in Uerleshuusen 

die Mutter, Morle? Müller, Beide in iierleshc^usen gestorb 



^der Vater Abraham Spier, Hände Ismann, die Mutter Dijia 
{gebr. Katz aus Oersfeld? 



\ 



'leiser Müller, Vorsänger aus Mansbach geb 6.5.1758 
Moria 2. Ehe bürdig aus Heinrichs gpb. lij.8.1783 

Wolf Müller geb 24. 10 •1811 



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//U^^(^ ^ 



n 



Zeugnis 



der 



PryfyoiigsK@[mimissi@o zy WOrzbyr 



über die 



ärztliche Vorprüfung des Studierenden der Medizin 



Herrn 





Demselben ist bei der mit ihm nach der Prüfungsordnung vom 28. Mai 1901 
abgehaltenen Vorprüfung 

1. in der Anatomie die Zensur: 




2. , ,, Physiologie 

3. ,, „ Physik 



4. „ ,, Chemie 



5. „ ,, Zoologie 

6. ,, ,» Botanik 



f» 



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»* 



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somit die Gesamtzensur 




-^ 



erteilt worden. 



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WÜRZBURG, den ^l 



.Der Vorsitzende der Prüfunqskommission, 





t' 



1 i 



AP" 



Würzburg,MLZ^^Mddi^(::!ß^fi?v?, 

J^rung von üntsrtranken u. Aschaffefläurg 

■^ '' J\^Kammer des Jnnern. 



M 



* 17 tc 




rg. 



ßl^^ 



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' 



/^^li^J>Ia>:immansAZnivGr9ität Würzburg. 



Kollegienbuch 



des 



Stiilfsrenilen der 'JllhOi/C^Th 



Herrn 



%!^nd.. c^iMi, 



ana 



^Wneiheili^iW 



Vorschriften 

die Inscriptions- und Honorarbefreiung betreffend. 



Die Inscn|»ti()ii bcpiniit im Wintersemester am lö. Oktober, 
im Sominerseinester am If). April und dauert bis 15. JMoveillber 
bezw. 15. Hai. 

Die Inscrii)tion geschieht in der Weise, daß der Studierende 
sich eigenhändig in die auf tiem Inscriptionsbureau oder bei dem 
eiu/ehien Do/cutoii aufliegenden Tnscriptionslisten einzeichnet, so- 
dann dein Ltiivorsitäts-(^uiistor das N'erzeichnis der eingeschriebenen 
Vorlesungen nebst Kollegienbuch — beide gleichlautend ausgefüllt 
— übergibt und die festgesetzten Honorare entrichtet. 

Die InMoription g^ilt als vollxogen erst dann, 
wenn das Honorar bezahlt und amtliche Bestätigung hierüber im 
Kollegienbuche erteilt ist. 

V^on der Honorarbezahlung befreite Studierende haben in 
gleicher Weise Verzeichnis und Kollegiet)buch ausgefüllt dem IJniv.- 
Quästorate innerhalb dCP Obigen Krifit zur amtlichen Be- 
scheinigung der Inscription vorzulegen. 

Xichtbeaclitans; vorntehender VorMchrIften 
Kicht die Mtreiciiaii{>; im ^tlartrii^elbache nach 
Mich. 



Hiebei wird darauf aufmerksam gemacht, daß <iie aufliegen- 
den Inscri[)tionslisten (iffentliche Urkunden sind und die Einzeich- 
nung in dieselben zur Annahme und Honorierung der betr. Vor- 
lesung ver[)flichtet, gleichviel ob die inscribierte Vorlesung auch 
besucht wird oder nicht. Die Zurückziehung einer Unterschrift ist 
nur während des vorgeschriebenen Tnscriptionstermins und auch 
hier nur mit Zustimmung des betr. Dozenten gestattet. 

Die Ver|)flichtung zur Honorierung der betr. Vorlesung, für 
welche sich der Studierende eingezeichnet hat, bleibt auch bestehen 
selbst für den Fall, daß wegen 2s'ichteinhaltung der Bestitnmungen 
in den Jt^ij 22 und 23 der Satzungeti die Streichung des Tnscribierten 
erfolgen müßte und eine Bescheinigung der Vorlesung in dem Ab- 
gangszeugnisse nicht möglich wäre. 

Andererseits kann durch eine Bescheinigung über gehörte 
Vorlesungei nur auf Grund der Einzeichnuug in die Inscriptions- 
listen erfolgen. 



Die gänzliche oder teilweise Honorarbefreiung- ist isowotll 
(Kirch den Nachweis der l>Ürfti{;keit als aucli den der 
Wärdigkeit des Gesuchstellcrs bedingt. 

Die Dürftiiskeit ist bei der erstmaligen Aiuneldung durch 
ein von der zuständigen lleimatbehörde ausgestelltes und von der 
einschlägigen Verwaltungsbehörde (Bez. - Amt, Landrat etc.) und 
Steuerbehörde beglaubigtes Vermögenszeugnis nachzuweisen. 

Dieses Zeugnis muß ersehen lassen : 

1) Namen, Geburtsort, Heimat (Wohnort der Eltern) des 
Kandidaten, 

2) Stand und Gewerbe der Eltern. 

3) ob Vater und Mutter noch leben, 

4) Zahl, Alter und Stellung der noch lebenden Geschwister, 
und ob sie versorgt sind oder nicht, 

5) den Betrag des Vermögens der Eltern und des selbstän- 
digen Vermögens des Kandidaten, soweit es amtlich zu 
ermitteln oder sonst bekannt ist. 

6) das Einkommen der Eltern und die (Quellen desselben, 

7) den Betrag und die (Tattung der Steuern, welche der 
Studierende oder dessen Eltern zu entrichten haben, 

8) den Betrag der Schulden des Studierenden oder seiner 
Eltern, 

9) die (Quellen und Hilfsmittel, durch welche der Kandidat 
bisher sich erhalten und seine Studienkosten bestritten 
hat, sowie den Betrag seines aus diesen Quellen flies- 
senden Einkommens, insbes. der Unterstützungen aus 
öffentlichen und Privatmitteln. 

Unvollständige, Husweichende oder unwahre 
Ang:aben in dem Zeag;niM(«e haben die AbweiMong 
des Gesaehes zur Folg;e. 

Im Falle wiederholter Bewerbung genügt eine Bescheinigung 
der zuständigen Behörde darüber, daß eine Aenderung in den Ver- 
mögensverhältnissen nicht eingetreten ist. 

Der Nachweis der Würdigkeit wird angebracht durch ein 
Zeugnis über tadellose Führung und durch ein Zeugnis über be- 
friedigenden Studienerfolg. 

Zu letzterem Behufe sind bei der Meldung im ersten Studien- 
jahre das Gymnasialreifezeugnis oder das sonstige Reifezeugnis zum 
akademischen Studium vorzulegen. 



Bei wiederholter B<'werbung bezw. bei Bewerbung in späteren 
Semestern ist die Würdigkeit durch Vorlage von Zeugnissen über 
tadellose Führung sowie über die bestandene Stipendium- bezw. 
sonstige gleichwertige J*rnfung (ärztliche Vorprüfung etc.) nach- 
zuweisen. 

Stipendienprüfungen werden nur einmal im Jahre und zwar 
jeweilig im Sommersemester abgehalten. Hicbei ist jeiler Sti|)endien- 
bewerber aus drei Fächern zu prüfen, über welche er Im TOraus- 
geffÄnS«*"**"» WinterNeniester ordentliche Vorlesungen 
im Sinne des § 27 <ier L'niversitäts-Satzungen gehört hat. Kol- 
legien, welche wöchentlich 8 Stunden bezw. 12 Stunden gelesen 
werden, sind hiobei doppelt bezw. dreifach zu rechnen, so daß z. 
B. ein Bewerber, welcher ein wöchentlich 12 stündiges Kolleg ge- 
hört hat, nur aus diesem einen Fache zu prüfen ist. 

Es müssen sonach Studierende, welche sich um Stipendien 
bewerben oder Honorarerlass anstreben wollen, ihr Studium im 
Wintersemester so einrichten, daß Sie den obigen Anforderungen 
genügen können. 

J)io zu Beginn des Wintersemesters ausgesprochene Honorar- 
befreiung gilt für das ganze Studienjahr, die zu Beginn des Som- 
mersomesters ausgesprochene nur für das betreffende Sommer- 
semester. 

Die an die Honorarienkommission zu richtenden Gesuche um 
Honorarbefreiung haben in Kürz? den bisherigen Studiengang und 
Angabe der allenfalls bisher gewährten Honorarnachlässe zu ent- 
halten und sind mit den erforderlichen Belegen bei Ver- 
nieulnng: der Xichtberneksichtigung - Winter- 
»eniester b!« läns^^ttenM 8. Xovember, im Honimer- 
Senienter bi» iäni^stens 8. Mai — bei dem k. L'niv.- 
(^uästorate einzureichen. 



J't^i^i-fSemesier 191 / 



Bezeichnung der belegten p^^^^ ^^^ Dozenten 
Vorlesungen. i 



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vta^, .kß^.^. 

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-J^äAtIv^ 



i?-W>'<*«.-**-«' E 










Honorarpflichtigkeit 



HoMorar- 
betraf 

Itfk. I PfK^ 



<6* 



?/ 



/ 



yi^j'lf 




•"nlSUfJ." ' Bescheinigung der Dozenten 

(nicht vorgeschrieben) 



Qaittors 



Mk. I Pfg. 






tf/r 



M^}iL. Semester \9\^//i^ 



Bezeichnung der belegten i j^amen der Dozenten 
Vorlesungen. 



^r^^^^ 




/^ (^^ 



Honorarpflichtigkeit 



Honorar- || Ouittung des || Bescheinigung der Dozenten 

betrag i Quästors , , . i v 

" " (nicht vorgeschneuen) 



PfK II Mk. I Pfg, 




■!*«S1 



.Ui;Ji4----Semester 191 ^/f.} 



Bezeichnung der belegten 
Vorlesungen 



Damen der Dozenten 



.'OM.-IM^M^ 





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Honorarpflichtigkeit 



Honorar- 
betrM 



'"oiSJH)»' 1 Bescheinigung der Dozenten 

' (nicht vorgeschrieben) 




ci • Semester 191 A 



Bezeichnung der belegten 
Vorlesungen. 



Tlamen der Dozenten 




I^_A 




Honorarpflichtigkeit 



Honorar- 
betrag 



'"oIa?ort" Bescheinigung der Dozenten 

(nicht vorgeschrieben) 



^^^^'^T!!''?^'*^ ^'i'r*^ 



KA.I^.'fU.Mu. 
















^^ ■ — -^ - 


Honorarpflichtig 




SemesU 


5r 191 


kftit ^ 






1 
1 








Bezeichnung der belegten 
Vorlesungen. 


Hamen der Dozenten 


Honorar- 
bitrag 


Quittung des 
Quistors 


Bescheinigung der Dozenten 

(nicht vorgeschrieben) 


Mk. 1 Pffe- 


Mk. 1 Pfg. 


..,.. ...^...v.... 


























1 



















• 





















































































r 



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Praktikantenschein. 



«» r»r-» «I 






Dem Kandidaten der Medizin 



t€^^ ^.y'//l^ 



aus t'^^i^^yupt 




<^^^c>Ce^.^x^ wird hiermit bescheinigt, daß er nach voll- 



ständig bestandener ärztUcher Vorprüfung im ''i<!<!^^i>i^,,^^ X^^^ 



vom 



Z/.>^ ^^^^'Ä. 1^^/^bis zum ^'^ dC^-^^' \/^f^ 



an der ohrenärztlichen Klinik als Praktikant regelmäßig teilgenommen hat. 



/ 






München, den 



-^ 



ten 




^Y.- 



19 />^ 



Der Direhtor der otiatrischen Klinik und Poliklinik. 




^ t I 






l t^ 



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r 



No. 



//f3 



n 



Praktikantenschein. 



Dem Kandidaten der Medizin {Vv»4- MaIWu. 



aus 



(äcli^^cJ^oJUk^^A/" 



vollständig bestandener ärztlicher Vorprüfung im ^^^»vua^M^- Halbjahr 19m 



wird hiermit bescheinigt, dass er nach 



cSo. 



vom 



1^ teil (Law^ bis zum jAten j^ü \g\ Lj. an der 



chirurgischen Klinik als Praktikant regelmässig teilgenommen hat. 



MÜNCHEN, den X^^n juü iQi ^ 



I 



% 



Direktor der chirurgischen Klinik. 




I 



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# 



r 



n 



> 



ftn^tyift 



etäbt. itranken^aud Mn^en tink» bet ti\ax. 



aeuflnM. 



(5» totrb bietmlt bepätlgt, baB ^err CJtnjl KütCcr bom 
18. ^eaember 1913 bi* 4. snärj 1914 auf bet ♦itutoifji^en 
Kbteilttng aU (JoaFfiftent tätiö toar. 
SHln^en, ben 5. mx% 1914 

9et Oberatat: 



gUr bie Kl$tiökeit bet tlbf(ttlft: 





>:;^-«v^-^-r/..'^V>*-^t-^;^...^i^^^ 



r 



y 



Inskription Nr. ^oQ 
Geburten gehoben : V 



H. S. Journal Nr.: 



i^^^^^^^W 



n 



Praktikantenschein. 



r 






Dem Kandidaten der Medizin \X^Afi^..X'^iL^^&M/.. 



aus 



.Q^v^>n<:aXI>l^<^^ 



wird hiemit bescheinigt, dass er nach 



vollständig bestandener Vorprüfung im C^/wwwt^ - Halbjahr 19 l^t 



vom 1 ? ten ßk^iA/iX 

\ ten (Ww^ 191H 



191 H 



bis zum 



an der geburtshilflich-gynäkolo- 



gischen Klinik als Praktikant regelmässig teilgenommen und ^ Kreissende 

in Gegenwart des Assistenzarztes selbständig entbunden hat. 



München, den \ tjn CUv^u^/yt 19/ If 



Der Direktor der KgL Frauenklinik 




AI l"ir,H'l 



iL 



r 



n 



^iäbt. «^ranßen^auö ^ünc^en finßö öer S^far. 




cugnis. 



€& tpirb I^ierburi^ beftätigt, 6<3§ 



f)crr 6inA^ 'M3^t 



r>om 



i^itn jbtAJL/^^ 



UA^ 



... 19 /l^ bis. k ten ^im.. 



19'1>+ 



auf ber ÜklMMAAA^^^^^ Abteilung als CoAA^t^>^'^.. 



'^ 



tatig wav. 



München, ben i^ i^ M.^i 



1 



<f 



"« 



Dorftetjcnbes Zeugnis lüitb f)ierinit amtlid) teftätigt 



Der J8)bcrar5t: 




^ranßenl^auö -pireRtion. 







V 20. (Wa. 2) 17. XII. 07. 1000. 



r 



n 






* 




eugnis 



ü6er die Teilnaßme an den 3Präpaner-%l6ungen 

6ei der 

%lnivevsUät Tjüüvzdurg. 



SDem Studierenden der SÜedizin iKerrn 




aus 




wird ßiemit ßescßeinigt, daß er im 




Winter-malöjadr 191i^^ vom 25. 0/cio6er 6is 2l- ''" ^^.^U^r^^c^^^^—an dem 
2. 3fCurs der anatomischen S^räparier-'Zlöungen regelmäßig teilgenommen ßat. 



%Uürz6urg, den ^4-^ 



191 5 





•^■(/ xn>^ 



Zur Beachtung: Gegenwärtiges Zeugnis ist aufzubewahren, weil 
öasselbe gemäß § 22 öer Prüfungsordnung für Arzte öem 
seinerzeitigen Gesuche um Zulassung zur ärztlichen 
Prüfung wieöer beizufügen ist. 



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'""''^''^ Der Stabtfetretär. 






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/y ■ :#^ ^^^^ 




r 



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eugws 



über die ^eifnaßme an den CSräparier^Q^bungen 



bei der 



QJniverßtät ^ürzhurg. 



CDem oftudierenden der Hl^dizin ^errn 





aus ^.<:^^^<-*<^-^^«-«^^*-<'«-«^^^ wird ßiemit befcßeinigt, daß er 

im ^inter^JfafbJaßr 191i \ll vom 25. Okiober bis If *ii. /t'^4s£r-^^ 
an dem A OQirs der anafomifcßen ^räparier-üibungen regefmäßfg 
feifgenommen ßat. 



^ürzburg, den 2^ ''" Y-^^-^C^^ /p/ ^. 







^10 *^«^*/^^^^^^^»^*^^*^»^/^ ^ ^^t-^^^^^^^^.^^^'^^^^cr 



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Ze 



ugnis 



über die Teifnaßme an den pßysiofogiscßen ü/bangen bei der 

llnwersifäf zu ^ürzhurg. 






Dem Studierenden der ^ediz, 



in 



9ferrn uty^^t/^/ 




aus 



im 





wird bescheinigt, dass er 



V. 



(TTii^pf^^d —' ^afbjaßr 79/ J 



vom 



bis 



Je 



Cj 



fen 




Xf'- 6c^rxy 



ft< 



an den pßgsiofogiscßen 



iibungen regefmässig teifgenommen hat. 



Würzbarg, den ^^J'" /x^ti/U jgjJ 





ty. 










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nbtv bie fcUnntiitie an bem dfcmifdieit ^rithtiltunt fttt* Pebi|itt(r 



bei ber 



Pnitteffttat ftt $UU 



1^» 1^ ji »«^ 



2)em (Stubierenben ber Webtain J^yi/n/>i f f^iiAÄ^JiX 

aug U(:Ji/niCLZ^ wirb {)termit befrf)emiöt, bag er im 

an beni cf)emifd)en ^^raftifuni für ^Jlcbiginer regelmä^ia teilgenommen t)at. 



ii«l, ben ...>^- ten ^^oU 19^5 



(Unterf(i)rift be§ Seiter§ ber Übungen.) 




(^eglaubignnö burcf) ben ^ireftor be§ 3nftitut§, fofern berfclbe nirf)t felbft fieiter 

ber Übungen gemefen ift.) 



<i i 



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63 



<yzaSitKanien:>crietn. 



^^etn (^anc/tola^en c/ez ^/Cec/tcn 



wtn 




aui> 



"WA^^osPiioXh/A/ 



Cx^nj^'Vfiu^ 



fDtra ntemt^ nedcnetnta^, c/ot^ er, 



naon t>o/fö^änc/ta oeo^anc/ener äzti&Hcnet ZC/oti>rüruna, tm W. (^Tiaioianr /P'/S/fu 



t>om 



OJMoW 



79 \^ ^t<> <&um (o ^^« WX^ 



/9^H 



an aer (^vüntK^ der ^L^n€/e^'K^an/cnetten a/c^ J^taK^mant zeae/tnäß>ta ^euae- 



nofnmen 



nat. 



^/lünc^en, den G ^^^ ^^Aj^. 79 \^ 



<Oer J/orc>ianol äez S. <==2tnivez:>iMh'(^utnc/erKt^ 



/ 



^ 



Nr. 19. 2000. 11 11. 11.50. 



r 



No. /W. 



n 



Praktikantenschein. 



Dem Kandidaten der Medizin ||uittM. iMA/yT'. 



aus 



^CA/^vwoXk.o^M^ 



wird hiermit bescheinigt, daß er nach vollständig 



bestandener ärztlicher Vorprüfung, im (wa^X^X^. Halbjahr \9\'iy^i^ 



H 



vom <ü l '*'" 



c>W<?W. 



bis zum I '«" 



1 



./^Haw... 



mH 



an der 



X. 



'AÄji^i/icI^iJtM/'. Klinik 



als Praktikant 



regelmässig teilgenommen hat. 



München, den 



\ 



ten 



Mm^.. 



Direktor der X- .-6MÜM^r^\i4 



191*^ 




Klinik 



m^ 



l s 



r 



No. ^i 



Praktikantenschein. 



n 



« ! 



:=aK: 



aus 



Dem Kandidaten der Medizin 



Mm^KidhA 



izin HilM .MiiMiAÄM:!::: 



wird hiermit bescheinigt, daß er nach vollständig 
bestandener ärztlicher Vorprüfung, im S^ß'iM^iMlA^ 



Halbjahr 191 



^ 



vom 




ten 



Äuüi 



bis zum V" ^e" 




ImIi 



m^ 



\ 



an der I. Medizinischen Klinik als Praktikant regelmäßig teilgenommen hat 



München, den Vv »•« 





huk 



191 



J/. 



cy\Aii 



Direktor der I. Medizinischen Kli 




il 



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IH 



Ji 



V 



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No.. 



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: 



Praktikantenschein. 



Dem Kandidaten der Medizin 



r 



izin ....m//ijri.& 




aus Je /? /yi€t l /f{X/€%€ ^'f^xxA hiermit bescheinigt, daß er nach voll- 



ständig bestandener ärztlicher Vorprüfung im 




/:^^/r^ Halbjahr 19 



/^ 



vom 






A 



bis z^xTR.^ ^^-MrCl.^U:.. . 

* X 



19 /</ 



an der ¥^, U< tl^^/'WC^/O^/r j>^/ U ^^^ Poliklinik als Praktikant 



^ 



regelmässig teilgenommen hat. 



München, den 7 i/^^ .<./..</<. .. 



^ 



19 



der Kgl. 



Der Direktor 



' Poliklinik: 




1 



'1 



> 1 



> 



H 



r 



n 






Zeugnis. 



Dass der Kandidat der Medizin 



Herr 




iv {iH^<^ 




e^i^ 



am praktischen Unterrichte in der Impftechnik teilgenommen und die zur Aus- 
übung der Impfung erforderlichen technischen Fertigkeiten erlangt hat, wird 
hiemit bescheinigt, zugleich wird bestätigt, dass er mehr als zwei öffentlichen 
Impfungs- und Wiederimpfungsterminen beigewohnt und sich die erforder- 
lichen Kenntnisse über Gewinnung und Erhaltung der Lymphe erworben hat. 



MÜNCHEN, 




l. /i/l 



i 



r^ ' 



r 

:> 



No. 31. 2000. IV. t3. 9.80 



r 



No. 



n 



Praktikantenschein. 



Dem Kandidaten der Medizin .&l^>i J^ 



aus 



.0 C>VM4^^ 



wird hiermit bescheinigt, daß er nach vollständig 



'd 



bestandener ärztlicher Vorprüfung, im <^r^ :^:^^rHU^ - Halbjahr 191 K 



vom 



^'^■■•'*" .örd/tA^. bis zum 3.0 ...ten ^^^ j^ji^ 



an 



der f^'^l^.l^ . -...udi^'l^U^ 



1i\ 



Klinik als Praktikant 



regelmässig teilgenommen hat. 



München, den 3? '«n ^AjJÜCf, 191 if 



Direktor der 



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24« Migup 1915 6i« 10« :^t|ember 1915 ouf ber inneren flMeituno B 
bed ue[tuno0(o|aiet tee !r4enr a^tan t)nt« 

JBei)cnbelt r^erben auf bcr : bteitunfl n ü^öeuaatifecr, ^aocn-, 
Sata- unb etof f;ae4'f eUranfec^ ettBevben i!^ ber ftation bie aanfe 
;^nf ekt icti^abteiluna angegUet^ert • 

•• tot bie: bie :tene eine* ttf f irenjarjt c* un: au!<y feit- 
^.elfe bi: Söctretutto bee orbinierenben HtjteÄ ber ctatinn Hbet* 
n€A;iaen maifen, ^v >at feine GteCCe ioiet ßeiBiffcniöft« en unb 
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IJef^nnBCagnrett 2. 




lUtigkeit ber -nbr^cift: 




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jaanbftbetrg aS*19»li« 1017 

Cert cönb. nel^. 3tnfi mutx au» otJmaClalb^n ip bom 21. 3an.l910 
bi» 21. 11, 1917 In ber mlCita^ir^en a^^atflö eine» 3*lböllf »atate» 
anbem meiner lieltung unt etjtet Cten PÄbtlf^fn Htanlien^auf e atft 
petlDerttetenber nff l[*er.$aTät ouf ber ^DlruraU^^en etatloa tötla 
fler^efen. 

fterr ljmct<rr t^ai ar. bet ^en?ältiöunß be» InfnCße befi frleoe» 

, , ^ flrofen operotlben 

ouf ba« 5tTonft^*niiuu^ eUr^töu enbcn »J.ctcrlat» In UtilerT Tefler unb 

ftelglger !:elfc tcUoenoBuien. tlu»ocrüret mit einet teilten fluf- 
fof funo-^cobc^ teitnlfCor: öefi^lö unb einen für feine Jungen Z<i%xt 
bemerUendbcrteu erm eii i'lltenr tat er fH In ben i^m infolge ber 
3eltbert)attnlf fe früfticltiü Übertraoencn :;if tUtenkreU f^ned eln- 
ßeorbeltet unb ble für Un »Unflße üttge fe^r au feinem BorteiC 
üuÄgenuft. S6cl unferem tögll*en 3uf CBiiienorbelt en konnte \^ a»i« 
bübon ttbcraeugen^ bag er bon Beginn feine» Stubium« on mit Örünb- 
tit^feelt/ ^Slfer unb Irfotg gearbeitet t^at, fo traten befonber» 
gute anatowlf»$e Renntnirfe a^ Tage, d» Ift mir eine Jreube geteeftn 
au fe'oen auf iretcjen guten Beben ble \\d) bei ber Unterfudfung bon 
-?ranhcn unb a<^**»c^nfCÄ au»o^?^^K^«n Oj)'»rot l onen ergebenben Semon* 
jlratUnen bei Um fleten. :3c} (abe bemgeadß Sertn Äülter annd^fl 
nCelnere r;inürlffe unter meiner «ufflc^t maejen Caffen, in bet 
testen 3elt bin itj Infolge meiner auf ue^rere ö«|arette berteiCten 
^Stigbelt bcau übergegangen, ibn felbfiänblg bor ft^btrere o^^etatibe 
«Aufgaben ju feCt en, ble er immer ju metner 3uf rlebcn^elt IHt^ 
S)ur« petlge« (tublun In feiner freien 3eit in ftevr «mit er iamier 
be,Uebt geteefen, fi<t toif f enfcjaft tl« fottaubltben unb ßüAen am»- 
aufüClen, ü)ie 2:ecfmlk ber nobernen GunbbetjanbCung be^etrf^te er 
boUftänblg* i 

S)ut<J feinen offenen unb geraben (J^l^arakter fötale hux^ ein 
freunbtlc^e» unb entgcgenkowmcnbe» Kefen tat Jerr fetter fl« ble 
6t)m)?attien ber ^tranken unb «erh:unbeten aC» au< bie meinige in 
bot lern 5<ate erteorbent 3# konn i^n für fpater a(» Äffipenaorgt 
befonber» auf euner ♦iturgifdSien Ctatlpn toarm emj^fe^Cen. -t t* ^ 




<. V 



>t<^^ 



?ll4tlgkelt 

fctitift: 



gea* ^r. ^eCke»Uaub 
Äeltenber »tat be» Stabt* Äranken^aufe«. 



/ 



r 



Jlr;tlid)e jOrttfungshtmitniffton 

Berlin. 



Berlin, ^e^ 



I 



^em .s^aiibibaten bei* ^})iebi^ui 




löivb. t)ienmt befcf)eini(^t, ban er H^t -ifiL.i^jditCuov Doi iuUtid)en jUnifunc^g^ 

QV5tha)ei\ 'iUnifung (u'fittbot uwb bicfo uoi ' in! *t ' 



tomtuiffiou 'Berlin 




b oonbüt 1)0 (nm ipU b. 



Ter Sefrctäv t)cv ^Prüfuugt^toiuimffiou. 



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'niiif!ia::lrr-i.ri.'il.eain§cni 



tarken-^nnf , d^h.lö. Harz 2918, 



Besehe int 



n g 



-■■ ' "■ j ' "- 



gfi ioird hiermtt bescheinigt, dass der Feldhilf 3 

^jorzt Ernst Müller Ceiegenheit hatte die Vorle- 



sungen der Köntgl, Universität Berlin U Winter 
Semester 1917/18 regelmässig t'{ besuchen» 




Markendori , . 

bei ;^/ 

der üntörsohilXt 




Stabr» und BegisJient samt 




lÄutiudr^u. stell veitr.Aijutant 



•«MMm 



r 



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K02:iiGLic:i: 

PRl^DRlGH-:71LH:^LivIS-ü:JiV-.RSlTAJr 



3erL in , de 




mf 



Ss wird hierdurch bescheinigt, dass der Studierende 
der Medizin Herr (Ä-t ^ JOU'&S^ 

ans !^n p/7/ikaMm^ j<W^^ ^/^^^am U. Jjm'^m/fr i9i;^ 

auf der hiesi^-en Universität immatr iknlier t v/orden ist^ 
und dass er derselben noch anp-ehört. 



am 
bisher 



Ferner wird bescheinif^l , das? er in 





die ärztliche Vorprüfung bestanden, 
Semester, einschliesslich /i^4r7i/w kli- 



nischer Semester, Vorlesungen belegt hat 
' ^ J Der Rektor 




'V.J^>C;:^ 



Besehe ini<^un^. 



i^A-y^^\yJ^ 




Ovv^^ 



£ 



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3^rc'ie;it);M ci'cr 



<^h 



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:r:t t 



Ar» 



3 '-- .r 



aM» j 



)n'n r 



r-» ^ »*-,,>• 



a r)at Vit/) i-, ßerbf. 1918 



et^ja ein ':3x ert c( ] al)r vertreten, '^r l)at e5 i)ar3'l3rx:'; ncrTraubcu 



ficf tc5 s?>ertva.icn bcr 3af 1 c:at cu 



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t)crfel)en banU ber reichen -^tcbl- 



iulfcV.'.'. v^cuut -ai ijc^ '\b(tx 'o\e ?i' becfl^ 



je 



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)U5t 




Tre 




Yere 



•&2? 



^r^£^^^^^^~y*;*t--;^ 



■MlMMMMaiiMMaiMMMMl 



«««yi 



MhM« 



rtIM 



1 



-I^^^f- *^ 



n 



prof. Dr. mti. p. Straßmann 

Sprfdijril: 4 7,-6 Ulir mitx Otmnftap 



ßrrliit «.»». 6, 28,7,19. 

Jd(t)iiinanii|lr. IK 
frrnftjr. Amt iloröfit 1690 



Merrn 



Dr. jfied. Ernst Müller 



Krankenhaus Treuen'bricken 



Sehr geehrter Merr Kollege^ 

Gernp Ibtn ich her ei t Ihnf>n 
Gelegenheit an meiner Klinik su gynäkologischer 
ferüollkonjJiniing f,il Tjieten. Es kann sich frei^ 
lieh vorerst nur um. eine Volontärstelle auf 
3 Monate ah l.Des.l.^. (ohne irgendwelche fer^ 
günstigung ) handeln. 

Mäheres wurde ich gern Rundlich rAt Ihnen 
in T.einer Sprechstunde tägl. von 4i-6 Uhr 
(ausser Donnerstags) hesprechen. 
Das Zeugnis schicke ich anhei zurück. 

Mit kollegialem Gruss 
ih7\ gans er^gekener 




-.-«««' II imil IMBIiHWlIHllWI ■■! I 



n 




atß CVcf.luCiri für nfercii-, 4aCl^ u, :^cf cr.^ra;:hici tcn cn bcr tciu 
pattc :.cfevt;clu:ari;it tatii hin, ein bcit UOcv ben 'i>ur4f4iiilt 
OeOcntcÄ : iffcn xi. ;.;5nncn in :cv -würt^nooCoölc anöccl^nct; er öc- 
^cvrfni bie r^e^n Ih bcr i an^nöci'aol) ie aul» unter er fc^herenben t.er- 
?j;;Ctni ffcn; cn:>viluri;ne.cale C^crc t lon-in auegi» führen ^Jc;r Ujvx tcUec 
t;clrc r,cleccnl?clt acö<^^vi:. uuC i:; Ui icvtiil: bcr Ctoöcopic unb 
r.Unc!copic !uv..lcs er tjröf^eu^ ^7cf4i .. :1^i« "airac bcr "dt :?ftnb einer 

Oes.: ""r. Turc^-cr^t 

Gut blc r:i<>tlo'i-it 
"i^ax l=:bfgrift: 

""'nbiirc 



Die ^imraitsfaj)e. 



v\ni 




r 



n 



PROF. O. WITZEL 

OBHBIMKR MKDIZINALHAT 



I 

i 



DÜSSELDORF, 

1 MOORKNSTRASSK 
TKLKFON 7700 



\ 



ii/e/h^a 044^ it4*i i^X-Ä^ywv ^'ku (^U4t /«y /,iu4. 

Je44i M^ ^^^^ 4^-^^UuH ^4^'^.^ ^^^^ rv/^^ 
'{fu'rUc.^ ^,^ UH4^ «Tä^ÄV^ ä^>^^^ >i,J^ 



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1023 
433 



UNIVERSITÄT MÜNCHEN 



n 



ZEUGNIS 
ZUM ABGANGE VON DER UNIVERSITÄT. 



' ) 



Herr Errist J L 11 CT 



aus Schmal ii aide n 



geboren zm S C h i'l a 1 h a 1 d 6 n 



ist vom 23.0Ktöber 1913 bis zun, Ende des oOuüfierhalb Jahres 1917 



als Studierender der Medizin 



\ 



t ■ 



an der hiesigen Universität immatrikuliert und auf die im angehefteten 
Kollegienbuch verzeichneten Vorlesungen inskribiert gewesen. 

Über seine Führung während dieser Zeit ist Nachteiliges nicht zu 
bemerken. 

Zur Bestätigung dessen ist dieses Zeugnis unter dem Universitäts- 
siegel ausgefertigt und von dem derzeitigen Rektor und dem Syndikus 
der Universität eigenhändig unterzeichnet worden. 

München, den 2, Dezember 1911^;- 



Der derzeitige Rektor 



z;^^; 



/ 



/ 



Gebühr 4 Mk. 




Der Syndikus: 



^ 




w 



r 



n 



Universität München. 



Kollcgiciibuch 



für 



Herrn stud. .,v\^x^ UiM/)l Mm^.... 



Die Titel der Vorlesungen sind im genauen voll- 
ständigen Wortlaut einzutragen, wie er im V^orlesungs- 
Verzaichnis aufgeführt ist. 

f^ei Bestellung eines Abgangs-Zeugnisses sowie 
bei der Anmeldung zu einer Stipendien-Prüfung ist das 
Kollegienbuch der Universitäts-Kanzlei vorzulegen. 



4r 



r 



n 



I. Inskriptions-Bestimmungen für die Universität München. 

Die Inskription geschieht in folgender Weise: 

1. Der Studierende trägt in sein Kollegienbuch und in ein von 
ihm unterfertigtes Inskriptionsverzeichnis jede Vorlesung 
mit der im Vorlesungsverzeichnis angegebenen Bezeichnung 
und mit dem Namen des Dozenten ein; die Inskriptions- 
verzeichnisse werden bei der Anmeldung zur Immatriku- 
lation und bei der Matrikelerneuerung ausgegeben; 

2. er übergibt sodann Kollegienbuch und Inskriptionsver- 
zeichnis gleichzeitig mit dem Kollegienhonorar oder dem 
Nachweis über Honorarbefreiung dem Quästor; auch für 
publice gehaltene Vorlesungen ist Kollegienbuch und 
Inskriptionsverzeichnis zu übergeben ; 

3. eine Quittung über den einbezahlten Gesamtbetrag erhält 
er sofort, das Kollegienbuch mit den Bestätigungen der 
Quästur und der Kanzlei über die vollzogene Inskription 
erhält er möglichst innerhalb der Inskriptionsfrist zurück. 

Eine Vorlesung gilt als belegt erst dann, wenn sie im Kol- 
legienbuch vorgetragen und dem Vortrag der Stempel der Quästur 
und der Kanzlei beigefügt ist. 

Andere Vorlesungen werden nicht in das Abgangszeugnis 
aufgenommen, auch nicht, wenn sie publice gehalten wurden. 

Bei Vorlesungen, bei denen der Eintritt nur gegen besonderen 
Ausweis gestattet ist, oder bei denen den Hörern bestimmte Plätze 
zugeteilt sind, oder bei denen der Aufruf der Hörer nach einer 
bestimmten Reihenfolge erfolgt, werden Hörsaalkarten, gegebenen- 
falls mit Platznummer ausgegeben. 

Die Ausgabe der Hörsaalkarten und die Nummer der Karten 
richtet sich nach dem Eintrag in die über die V^orlesung geführte 
Hörsaalliste. Die Hörsaallisten liegen vom 15. Oktober bis 
15. November und vom 15. April bis 15. Mai in der Quästur 
oder in dem betreffenden Institute auf. 

Für die Einzeichnung von Ausländern in die 
sind die etwa bestehenden besonderen Vorschriften 

Die Annahme der Hörsaalkarte verpflichtet zur Inskription 
(Ziff. 1), wenn die Karte nicht bis zum 8. Mai bezw. 8. November 
wieder zurückgegeben wird. 

Die Frist für die Einreichung der Inskriptionsverzeichnissc 
und die Bezahlung des Kollegienhonorars auf der Quästur (Ziff. 2) 
beginnt im Wintersemester am 15. Oktober, im Sommersemester 
am 15. April und dauert bis 15. November bezw. 15. Mai (§ 25 
Abs. I der Satzungen). 

Eine spätere Einreichung und Bezahlung findet nur ausnahms- 
weise mit besonderer Genehmigung des Rektors statt, wenn ein 
ausreichender Entschuldigungsgrui d nachgewiesen wird. Jedoch 
ist auch dann, von besonders berücksichtigungswürdigen Fällen 
abgesehen, der letzte November und der letzte Mai der äussersle 
Termin (§ 25 Abs. II der Satzungen). 

II. Bestimmungen über Honorarbefreiung. 

Die Bestimmungen über Honorarbefreiung finden Anwendung 
auf landesangehörige Studierende und auf Studierende solcher 
deutscher Bundesstaaten, die Gegenseitigkeit üben. 

Ueber Gesuche um Honorarbefreiung entscheidet eine eigene 
Kommission (Honorarienkon mission), die aus dem Rektor und aus 
einem von jeder Fakultät (Fakultätssektion) aus ihrer Mitte ab- 
zuordnenden Mitgliede besteht. 

Die Honorarbefreiung ist durch die Dürftigkeit und Würdig- 
keit des Studierenden bedingt. 

Gänzliche Honorarbefreiung wird nur bei voller Mittellosigkeit, 
teilweise Befreiung dann gewählt, wenn zwar volle Mittellosigkeit 



Hörsaallisten 
massgebend. 



i 



f 



A 



nicht nachgewiesen ist, die Verhältnisse des Studierenden aber 
eine billige Berücksichtigung erheischen. 

Für die Höhe des Nachlasses ist der Grad nicht nur der 
Dürftigkeit, sondern auch der Würdigkeit massgebend. 

Die Dürftigkeit wird durch ein von der zuständigen Behörde 
in gehöriger Form ausgestelltes Vermögenszeugnis nachgewiesen. 

Das Zeugnis muss enthalten. 

1. Namen und Geburtsort des Studierenden, 

2. Wohnort und Beruf der Eltern und die Angabe, ob Vater 
und Mutter noch leben. 

3. Zahl, Alter und Stellung der lebenden Geschwister, sowie 
die Angabe, ob sie versorgt sind oder nicht, 

4. den Betrag des Vermögens der Eltern und des selbstän- 
digen Vermögens des Studierenden, soweit es amtlich zu 
ermitteln oder sonst bekannt ist, 

5. das Einkommen der Eltern und dessen Quellen, 

6. den Betrag und die Gattung der Steuern, die der Studie- 
rende oder seine Eltern zu entrichten haben, 

7. den Betrag von Schulden des Studierenden oder seiner Eltern, 

8. die Quellen und Hilfsmittel, durch die der Studierende sich 
bisher erhalten und seine Studienkosten bestritten hat 
sowie den Betrag seines aus diesen Quellen fliessenden 
Einkommens, insbesondere der Unterstützungen aus öffent- 
lichen und Privatmitteln. 

Im Falle wiederholter Bewerbung genügt eine Bescheinigung 
der zuständigen Behörde darüber, dass eine Änderung in den Ver- 
mögensverhältnissen nicht eingetreten ist. 

Die Würdigkeit wird nachgewiesen durch ein Zeugnis über 
tadellose Führung und ein Zeugnis über befriedigenden Studienerfolg. 

Der Studienerfolg wird beurteilt bei der Meldung im ersten 
Studienjahre nach dem Reifezeugnisse, bei späteren Meldungen 
nach dem Zeugnis über die Stipendien- oder eine sonstige gleich- 
wertige Prüfung (ärztliche Vorprüfung usw.). 

Ob an Stelle solcher Prüfungszeugnisse auch Zeugnisse über 
die tätige Anteilnahme an Seminaren, Praktiken oder Injtituts- 
übungen treten können oder neben ihnen vorzulegen sind, wird 
yon der einschlägigen Fakultät bestimmt. 

Hält die Honorarienkommission nähere Aufschlüsse für wün- 
schenswert, so wird der Vorstand den Studierenden vor sich rufen, 
um Aufklärungen von ihm zu verlangen. 

Ein Gesuch um Honorarbefreiung, für das die Unterlagen in 
unvollständiger, ausweichender oder unwahrer Art erbracht werden, 
wird abgewiesen. 

Ein Studierender, der gegenüber der Ho.iorarienkommission 
unwahre Angaben macht, hat ausserdem disziplinares Einschreiten 
zu gewähren. 

Gesuche um Honorarbefreiung sind mit den erforderlichen 
Nachweisen bei Vermeidung des Ausschlusses innerhalb der von 
der Honorarienkommission bekannt gegebenen Frist einzureichen. 

Die zu Beginn des Wintersemesters ausgesprochene Ho.iorar- 
befreiung gilt in der Regel für das ganze Studienjahr, die zu Be- 
ginn des Sommersemesters ausgesprochene ausschliesslich für dieses 
Sommersemester. 

Gegen die Entscheidungen der Honorarienkommission findet 
Berufung nicht statt. 

Die Gesuche um Honorarbefreiung haben in Kürze den bisherigen 
Studiengang und Angabe der allenfalls bisher gewährten Honorar- 
nachlässe zu enthalten und sind mit den erforderlichen Belegen bei 
Vermeidung der Nichtberüclcsichtigung — im Wintersemester 
bis längstens 30. Oktober, im Sommer-Semester bis längstens 
30. April — schriftlich bei dem Univ. Quästorate einzureichen. 



r 



n 



Angabe der Honorarpflicht : ^o^i, ' ,ob frei, '/s, 'k. »/», -/•, oder ganz) 



Bezeichnung der belegten Vorlesungen 

im vollständigen ^Vortlaut 



Semester 19 A^ 



'/\if 



o^ouoAiM^l^- Yj^^ri<?Lc\A^U, ^w(Jl 



Zahl 

der 
wöchentl 
Stunden 



-C\A\M^A\^^ 



in. 



U(AiAUlAlLAUAAvUiAVVV«t. \vi. aJ^i CIxaA^^ 



O 



|/l'ltuv>wtvtu,4tt jit^vniy)^ /4/iA/ 







7 ■ L O 



"^^Ujo^ 



J'i^A^.\M/ihJlQ^^hluiAJ^ 



j2/wwv?Ci 



c5a«<4iv^J/Jf 



ir 



^ 



Ä 



Namen der Dozenten 

in alphabetischer 
Reihenfolge 



/O 










J}^ 



/l 






Bezahlt 



Einbezahlter 

Honorar-Betrag 

inkl. Dienergeld, 

Praktik -Beitrag 

u. Instit -Gebühr 



^1 '- 




4 ^b 50 



[UnrZüiMirrHunchenl " 



Bescheinigung der Dozenten 

(nicht vorgeschtieben) 








r 



n 



Angabe der Honorarpflicht (ob frei, »/b, «/.., '-., Vi oder ganz) 



Bezeichnung der belegten Vorlesungen 

im vollständigen VST'ortlaut 



Zahl 

der 
wöchenti 
Stunden 



Namen der Dozenleo 

in alphabetischer 
Reihenfolge 




Einbezahlter 

Honorar-Betrag 

inkl. Dienergeld, 

Praktik.-Beitrag 

u. Instit.-Gebülir 



Bescheioigang der Dozenten 

(nicht vorgeschrieben) 



r 



n 



Angabe der Honorarpflicht: 



Bezeichnung der belegten Vorlesungen 

im vollständigen Wortlaut 



l^ßl" Semester 19^ 14/15 



Sormer - Semester 1915 



J^inter - Semester l^lo/ 16 



Somaer - Semester 1916 



Winter - Semester 1916/17 



.Somaer - Semester 1917 : 



beurlaubt; stund im Heere. 



^sT^ 



V 



A 





/ 



(ob frei, V»» '^Z^» ^\^^ ^1^ oder ganzi 



der 

wöchentÜ 

Stunder 



Namen der Dozenten 

in alphabetischer 
Reihenfolge 




Einbezahlter 

Honorar-Betrag 

inkl. Dienergeld, 

Pralttik.-Beitrag 

u. Instit-Gebühr 



Bescheinigung der Dozenten 

(nicht vorgeschrieben) 



r 



n 



Angabe der Honorarpflicht: 



Bezeichnung der belegten Vorlesungen 

im vollständigen Wortlaut 



-Semester 19 



(ob frei, »/s ''h, »/s, 'h oder ganz) 



Zahl f 
der 
wöchentl. 
Stunden 



Namen der Dozenten 

in alphabetischer 
Reihenfolge 



Einbezahlter 
Honorar-Betrag 
inkl. Dienergeld, 
Praktik.-Beitrag 
u. Instit-Gebühr 



tM* 



0. 



Bescheioigung der Dozenten 

(nicht vorgoihrieben) 



-- 4 



VI Vt 



■■«■•■■■■R 



r 



1 



1 



J>14tiijLt 



üanbd^era a.b.C •^10.1117 



terr conb, mcb. Mnr Tülttx flu# t^naCkcrben ip bo£ 21. 3an»16 
Mi 21. 11. 1917 \r\ y>^x m» nt:^rU'«T> (T^ctce eine« : eCb(|it f larat«* 
an b«« :nelner .'2eltunö untetftlCtcn räbtif^ten Prenhenftcur^ «t« 
ne( (bf ctrete.ibci i-^f firenjarat au( r>$x i^itut^if '.en etotion tätlQ 

auf brt^ .eionUcn^aw!» einrtöi'i«nb«n otaM« ot^eratioen ^oteriaCl in 
äuSer,'^ xt^^i unb fCcigijjex elf« t ?l C^enomfen. nu#cerUret j^it etiet 
Cel4t«n i^uf farrunc«^Qabe, teAuifd^ew defti« unb eine» für feine 
Junöcn 'jatyce bemeirtten*fcetten ecn^e:^ HCCtn bot et fl4 In bew Ibw 
infoCo? bev 3«itt)^t^>uCtnif f e ftUbicitlo 'Ibi^rt casenen ^fCltJttn- 
krei« f't^ncCC einj^eoTbeitftt unb bi« fit i^u gUnriQe P.a^^ fe^t 0U 
feine»' :jortei( ausgenützt, ^ei anfcreai tagilcf^tt Cufa:«. cnat^eitÄn 
Uonnte i* '^\^') ^a^i>r\ U^ctjcuoen, baC er bon ^ealnw feine» rtubiuw* 
an 3tit (5rUnbCii^l?eit, 'HTer unb CxfoCo ßeocbcHft i^ct, fo traten 
befonberö oute anctoulf.:»c lienrtniffe gu ':raoe' ^''ft IP wir eine Hteube 
aeb^cfen gi; ffiien aiif retten ble fi* beV br. '!nt difui^uny t)oti Uranien 
unb ^cricinfciir, «nÄocfUl; rtcr ü^ci öf • iwiei. aißcbei.btn ^ewonprationen 
bei Ur. flc(cp. ;':(^ {)at(> beagc^-St ^crvn V'Mi ex f.ui\öe!jr fetclnete 
ßiiurlffe ur.tcr meiner ^iuffUt roden teffen, in bet testen /Jeit 
bin M infoCi^c rf.einer auf mebtere loecrttte betteilten iStiotieit 
b03U übetgecan^en^ ibn feCbpanbig bot fiffcefete «^etati^e rufgaben 



|u. [eUen, bie er intnet |u meiner 3ttf tiebenbeit i'6?% 



. lttT4 /etiaei 



ttubium in feiner freien 3eit ip 4etr PUder i 



it.Atx bei^rebt ge^efen 



fi« teiffenf(;afft(i(t^ fottaubitben unb i:ilAen aul|ufiiuen. ^ie te«ni& 
ber »obernen lunbbe^onbtttnß bebertf^te et bocrpdnbio. 



ut« feinen offenen unb oereben '^^ctckter foteie but* 



ein 



freunbCi^e» unb ent oefienkamenbei tiefen (at fietr IKllCet fi* b*a 
einmbat^ieen ber tranken unb ^etfcunteten aU au« ble «einioc in 
bödem .ait erteotben. 3« kann i^n fUr fbäter aC« Äffipeniatit 
befonber« auf einer d&itatoifc^en Ctßtion aarm evipfeb(en. 



Hf^x bic .'^i(bllnUeii 
.^T^r- ^^^ ^it>f4tift: 




gef« ^t* SeCkefka»!» 
^eitenbec nx%i be* Stöbt. 5^ranken^aufei. 



i 



n 



r 



L ^ 



Harburg, den 28. 4. 33. 



^ 



n 



fferr Dr.-Sm.-it M U 1 J mr 

war in der Zeit von Januar bis April " 
1915 mit mir bei R. I. R. 270 im SchUthngraben an der Westfront. Das Regi» 
ment hielt dwi Abschnitt bdsetst, westlich von Nesle bei den Dörfern Chilly 
und Hallu. Meine Kompagnie , welcher Herr Dr. Ernst Müller als Unterargt zugeteilt 
worden ujar,lag etuxx 200 m dem französischen Schütsengrahen gegenüber. Die Krx^ * 
te mussten damals auf besonderen Befehl stets mit in vorderster Linie sein. 
Herr Dr. Müller, als Arxt von 1/ 270, Es war Herrn Dr. Müller erlaubt worden, 
sich einen eigenen unterstand xu bauen. Da dieser Unverstand Jedoch verschie= 
dene Male von den Franxpsen zusammengeschossen wurde , nahm ich Herrn Dr. Müller 
«( in meinen Unterstqnd . Ich hatte daher vollauf Gelegenheit, Herrn Dr. Mül^ 
1er als mensch, als krzt und als Soldat kennen und schätzen zu lernen. Nach dem 
Kriege wurde siitens eines Militärlazarettes bei mir angefragt, ( wenn ich nicht 
irre, war es LucXenuxilde ,Job Herr Dr. Müller würdig sei , das E. K. zu erhalten. 
Ich habe damals meiner Entrüstung Ausdruck gegeben, dass Herr. Dr. Füller die^ | 

se Auszeichnung nicht schon 1919 erhalten habe, und ihm zur Verleihung des S. K. 
vorgeschlagen* Ich führte damqls an, wie Herr Dr. Müller bei einem kleinen Few 
erÜberfall , wobei wir den ersten Verwundeten hatten, durch sein entschlossenes 



Eingreifen die Stimmung der Mannschaften wiedrr auffrischte . Wie ich von Re^ 
gJ^entskameradan damals gehört habe , hat er sich auch bei dem Durchbruch von 
Qorlice stets als tüchtiger Soldat und Arzt geXzeigt.Ich persönlich erinnere 
mich gern seiner als eines bescheidenen, vornehmen Menschen. 



< 



^ut^i S 6Uip^^^^ 



y 



kgl. preuss. Hauptmann d. R. a. D. 
damaliger dberleutnaf bei I / 270. 



>(rf&^ -nxy<^<ü '^^ey^a^tc^ ^1^[^£a.^^ > 



ll/J jyc/ ,^>C^*l'^ • 



- ><./ 



(fi,f,V-c,:r. 



yvxA-^ a: / 



16763 



•V'll 



r 



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I 



Israelitische Gemeinde 

Schmalkalden 



9 Ifei 



1933 



Schmalkalden, den 19 



Au33Ug aus den Gcburts-Heirato- Sc Sterbe-Rexcister der 
israelitischen ^remeinde Schir.- Ikalden. 



"betrifft Eltern, Gro33Gltern, UrgroGseltern des 2U Sclirnalk.-lder 
Geborenen, jetzt in Nürnbcre \'7ohnhaf ten Herrn Dr. ned, Krnst 
Müller, c^boren am 26 Febru- r 1893. 



1. Eltern: 



Va.ter: Josef Müller, ceb» zu Mansbach , 
Mutter: Klara Mi"41er geb. Mand-l,^eb. am 26 Juni 1865 
in Schirialkalden. 



2. Grosseltern: Liebm,-nn Mandel, -eb. am 26 März 1826 zu Schmcalkalden. 

Fanni,geb. Eckrnann, ^eb. am. 26 August 1844 zu Schmalkalden. 

3. Urgrosseltern. Liebmann lviandel,ceb. zu Schmalkalden, am? I>e.3embar 1784 

gestorben am. 26 ITovemiber 1825 ' v 

Klara, ;:eb. Levi, gest. am 3o M-irz 1859. 



Der Synagogen-Aeltestr 




\ 



r 



Sgn. Aöw, St0ll0 III. A. K. 
San i t ä t a a m t 
No. 1819. / 



Berlin W.:^5,dm 20. Juli 1920. 
Potadameratraße 56. 



n 



BESCHEINIGUNG. 



c 




Dem praktiachm Arst Harm Dr. ERNST 
M U E L L E B wird auf aainan WUNSCH baaohainigt. daß er 



am 



9. 8. 1914 ala Kriagafraiwilligar bat 



dar 2. Komp. Erm. Batl. Jnf. Be^t. 83 aingatratan iat. 

Durch Verfügung daa a tallvart raten ten öenaralkdo. 
XI. A. K. vom 4. 1. 15 IVb No. 1012 iat er xum Sanitätaanit 
III. A. K. veraatzt uncTu^tar ihm, Dianet getan bia zum 28, 
2. 1919, dem Tage aeinar Entlaaaung aua dem Heere. 

Gemäß Verfügung dea atellvertretenten General^ 
Kommandoa XI. A. K. uorn ü. 9. 14 IVb No. ÄMMM/ 7142, be- 
atätigt durch Verfügung dea Kriega-Miniateriuma vom 28.9. 
1914 No. 3569/9. 14 M. A. iat er zum Feldunterarzt , durch 
A. K.O. vom 26. 1. 1917 zum Feldhilf aarzt ernannt worden. 



Der Voratand: 




/. 



m4 



r 



n 




gebortn am Z*^ ten Z"^^^-. 18 /^'* )u 



/- 



:5u^maiiu*v;;»v 



^t:ci§ toirb hiermit be^ufS ftanbeÄamtUc^cn SlufgebotS 



bcf (peinigt, bafe^^ÄT' felbc feit 




m M £ ^^ 



l^icrfelbft roo^n^aft 



z. ^ 




Sc^mallialben, ben 





192 




ie ^olijeioettDaltung* 





r 



n 



Polizeidirektion Nürnberg-Fürth . 



Nürnberg, den. 



./^:.(^^...192b^ 



Leumundszeugnis. 



Auf Grund der Erhebungen wird hiermit bestätigt, daß über den 
Leumund de s Px.Ä.aenÄrz.t.e.a 



.?.?.?.?.?!^...?!.^j.....^M.*....?.?.?.st M 



geboren am .26^1eferay.r...l893 zu ..SchraÄlkÄldfin.^. 



.P.?:eußis.cher. 



Staat sangehöriger , .m^. 



ouch^jji politischer Bezieh^mg 

Nacht elllge^s hier nicht bekannt ist. 



Geb. Reg. Nr. 



390 



Gebühr RJf ?.!.§.4 bezahlt. 

6971. 



Form. Nr. 823. H. 11.XII.30/5000 . 



K'. 






K.B. 




^Mv^/ 




7i ^ 



r 






M ...45, b„ 1S9, 



■JBOi^i^aUiJMMH« 



2)i߀cl)i[>cit nmjtch^nbör ^ferfigurtg, 

Siccjcini vj li::*) llnlerfcbrift 

triiö li:i:.if bourFu4I^ct. 

«öu®berfcoiilieu u. iWittelf ranb 

Kammer tes 3nncf'" 
3. 81. 



%^^«^«,.1?....RM.^ Ptg, Siaatsgobührtn 

r IT ?^-^--. # Züsdilaa' 

'- « -..••- Volimaditsttmpfl 

**" ly i, 2usdila(t 

^■•r-r,,,,,^,. ^ ,y< — ,1 Postgebtthratv ^ 




#••* 




V'^<.!C . 



"«.•^^t v 



i 






r 



n 



ArzfliJier BezirksYerein 
Nürnberg 

Bankkonto : 
Darmstädter- und Nationalbank Nürnberg 

Postsctieckkonto : Amt Nürnberg Nr. 5305. 



Fernsprecher 21291 



Nürnberg I, den 21.X.1 933 . 

Adlerstraße 15, SchlieBfach 



B e 3 t ä t i g u n g 



Herr Dr. Ernst M ü 1 1 e r ist als Facharzt für Chirurgie 
unl Geburtshilfe seit November 1920 in Nürnberg niedergelassen; 
während seiner 13 Jährigen ärstl .Tätigkeit in Nürnberg ist vorn be- 
ruflichen Standpunkt aus nie etwas an seiner Praxusführung zu bean^ 
standen gewesen, noch sonst etwas ehrenrühriges gegen ihn vorgelegen. 
Auch als Kassenarzt hat er niemals zu irgend einer Beanstaniung Ver- 
anlassung gegeben. 



AerHlwher Bezlr7:sverein 



(x^yU^'uf^ 



?*,• J. .-■.>, -.«t, <^-<'-',r :••■-.*** ->- ■■•>'■■ - *-^- -II '■ --,f --iTfttfctrt" 



r 



n 



Abschrift. 



Bescheinigung» 

Herr Dr Ernst Müller, geb. am 26.2.93, hat sich im 
Jahre 1921 in Nürnberg als Facharzt für Chirurgie und Frauenkrank- 
heiten niedergelassen. Mit seiner Niederlassung wurde Herr Dr Müller 
Mitglied des ärztlichen Bezirksvereins Nürnberg, also des Standesvereins 
der Nürnberger Ärzte, u, der Krankenkussenabteilung des späteren 
kassenärztlichen Vereins Nürnberg. Der Unterfertigte war bis Ende 
März d. J. ärztlicher Geschäftsführer der genannten Vereine. 
Herr Dr iviüller war immer ein einwandfreier, standestreuer Kollege 
u. hat sich durch seine grossen Kenntnisse, durch seinen grossen 
Pleiss, durch seine grosse Gewissenhaftigkeit u. durch seine stete 
Hilfsbereitschaft bei Tag u. bei Nacht einen grossen Kreis von 
Patienten in allen Schichten der Bevölkerung erworben. 



Nürnberg, 23. 10.33 

San. Rat Dr Steinheimer. 



Gesch. Reg. Nr. 1736. 
Die Echtheit vorstehender Unterschrift des Herrn 
Sanitätsrats Dr Ludwig Steinheimer in Nürnberg, 
Bucherstrasse 20a, wird hiermit beglaubugt. 
Nürnberg, den dreiundzwanzigsten-23» Oktober 1955- 



neunzehnhundert dreiunddrei ssig-. 

Bayerisches Notariat 
Nürnberg II 



Wittmann 
Notar. 



r 



n 



\. 



Abschrift. 



Pr. Ministerium 
des Inneren. 



Nachdem der Kandidat der Medizin Ernst Müller aus Schmalkalden 
am 27. November 1918 die ärztliche Prüfung vor der Prüfungskommission 
in Berlin mit der Zensur "gut" bestanden hat und der von ihm geleistete 
Kriegsdienst auf das Praktische Jahr angerechnet worden ist, wird ihm 
hierdurch die 

Approbation als Arzt 
mit der Geltung vom 27. November 1918 ab für das Gebiet des Deutschen 
Reiches gemäss § 29 der Reichsgewerbeordnung erteilt. 

Berlin, den 17. Dezember 1918. 



Ministerium des Innern. 
Im Auftrage. 
Kirchner 



Approbation 
für 
Ernst Müller 
als Arzt. 

Ä. 18650. 



Stempel: 1,50 M. 
Nr. 618. 



Docjiel^enbc nbfdjrlft flimmt mit &er Urf^rift üfcmhu 



/f1^ ) 







../T.i:, nbtcilung 96. 



1^.-» 



'^'4i^ 



r 



n 



.^SlMi^ Jnstizobsrsekrgtär 





Die üS^lffMIfllü Unterj^nft bes 

Utfunbsbeamtcn bec gefcf^ä^sfjcllc öes 
ilmtsgeric^ts In vilfLL[/kt/....mx^ 

Berlin, h^.MuA^±^^mm /w 

2)cr ^Imtsgen^ntsptaflbent 




Gesehen nx Eeglaubigurg der 
/7V"i stehenden UntefiClitift 

Berlin, d^n'^ ^euJih /pj 

di3 Deutgjdaea R^ula. 

[ulUag: 

Reimke 



r 



n 



1052.108 



Abschrift. 



1912/15 



OBERREALSCHÜLE zu SGHMALKALDEN. 



ZEUGNIS der REIFE. 



Ernet Müller 
geboren den 26. Februar 1893 zu Schmalkalden, Kreis Herrschaft 
Schmalkalden jüdischer Konfession, Sohn des Drogisten Joseph Müller 
zu Schmalkalden 
war 9 Jahre auf der Oberrealschule und zwar 2 Jahre in Prima. 



I. Betragen und Pleiss: 



1# Betragen: gut 



2. Fleiss: 



sehr gut 



Er wurde von der mündlichen 
Prüfung befreit. 



II. Kenntnisse und Fertigkeiten 



1. Religionslehre: (Auf der Schule wird jüd. Religionsunterricht 

nicht erteilt.) 

2. Deutsch: genügend. 



3. 


Französisch: 


gut. 


4. 


Englisch: 


gut. 


5. 


Geschichte: 


gut. 


6. 


Erdkunde : 


genügend 


7- 


Mathematik: 


gut. 


8. 


Physik: 


gut. 


9. 


Chemie : 


gut.. : 


10 


.Naturgeschicht 


e : 


11 


.Turnen: 


genügend 



12 . Freihandzeichnen : gut . 
13« Linearzeichnen: 



14 «Singen: 



15 .Handschrift : genügend 



f M 






r 



1 



V*» 



Die unterzeichnete Prüfungskommission hat ihm demnach, da er Jetzt 
die hiesige Oberrealschule verläset, um Medizin zu studieren, das 

Zeugnis der Reife 
zuerkannt und entlässt ihn mit den besten Wünschen für seine Zukunft. 
Sohmalkalden, den 23. März 1911. 



Königl. Provinzial-Schul- 
Kollegium. Cassel. 

Königliche Prüfungskommission: 



Th. Kaiser, 

Kaestler 

Homburg 

Schmidt, 

Heyfelder, 

Dr Amelung 

Henkel, 

Dt Kreiten 

Jäckel 



Königlicher Kommissar. 

Vertreter des Kuratoriums 

Direktor. 

Oberlehrer. 

Oberlehrer. 

m 

Oberlehrer 
Oberlehrer 
Zeichenlehrer 
Ramb. 



Er hat an dem den drei obei-sten Klassen der Oberrealsohule ange« 
gliederten wahlfreien Unterricht im Lateinischen mit befriedigendem 
Erfolg teilgenommen. 

Schmalkalden, 23- März 1911. 



Oberrealschule 
Sohmalkalden. 



\ 



Homburg 
Oberrealschuldirektor. 



norftehcnbc nb[cl;jnff pimiitt mit Öcr Urfd?nft üBeref 



ereilt 



."VC"« 

- »1 




^^. ^JW-^^i^^-'w^Ur /fß f 



• *^*"r j ' •>' 






Länm., i(c»,., 



•,ai)ir ^ 



mam 




r 



n 



jetzt 
as 



Lkunf t . 













••»•*•••••• 




Jnstizobsrsskrttir 



ange- 
lndem 



Urlunbsbeamtcn &et(Q<5cf*äftspcne {«s 

Jltntsgcri^ts lrt...„.i^£<tÄä^. ipir& 

hiermit bcglaubtgi y^ ^ y^^Jj 

Salin, ^^cJjLJ£^±Sd^^^ ^^'^'^^ 

Der 21mtsgejfwfoisprafib«nt 





I 



Gesehen rar Ccslaubigurg der 
Z^;^ glebenden Unterüchriit. 

Berlin, den-/^ kiftUMäik/flj, 

Das Auswärtige Amt 
des Deutspten Reichs. 

ftebnkfi ^ 



4 



1 



I 



r 






^'^'^^■f^'^ 






Gesch. Rag. Nr. 1736. 



'^$p( y^fZ- i-h/ ^^® Bolitlieit vorstehender Unterschrift des 
^J ,P^*f>f^''-^OuaQXxn Sanitätsrats Br« Ludwig Steinheii 




^^^^t^^< M--A 



■> m e r ^ in Niirnherg, Buoherstrasse 20 a, 



wird hiermit heglauhigt. 
*v/^*^lirnl)erg,den dreiandzwanzigsten-23. Oktoher 1933- 



<^' 



neaazehnhundertdreiuiiddreissig-* 








n 



Die Echtheit der vorstehenden Name nsunters ehr ift des 



r 



n 



/ 



V 



bayerischen Notars Justizrats Wj ttmann am Notariate 
Nürnberg II wird hiermit mit dem Beifügen beglaubigt, dass 
der Genannte zur Vornahme der vorstehenden Beurkunding berech- 
tigt und diese den hier geltenden Lanäesgesetzea gemäß erfolgt 
ist • 

N ü r n b e r g , den 51. Oktober 1953. 

Der Präsident 
des Landgerichts Kürnberg = Fürth : 



^^e^\ 



A/ mi.Geb.f-Begl. N"^ 
^ RM.Geb.f.Zeugti. 
_/^RM.205S Zuschlag 







Sa.^/£HM. 



f<r^^^^'}[$fj 






r 







n 




Nachdem der Kandidat der Medizin Ernst Müller 
aus Schr/ial Halden am 27. November ims die är rötliche Prüfimg 
vor der PrüßjngskomMission in Berlin mit der Zensur 
"gut'' bestanden hat und der von ihm geleistete Kriegs- 
dienst aU'f das Praktische tfahr angerechnet worden istj 
wird ihm hierdurch die 



Approbation als A r x t 
mit der Geltung vom 27. November 1918 ah ß'lr das Gebiet 
des Deutschen Reiches geniäß f 29 der Bei chsgewerbe Ordnung 
erteilt. 

B e r 1 i n, den 17. Dezember 1918. 



i'- 



Ministerium des Jnnern 
t/m Auftrage. 



Approbation 



f'ir 
Ernst Müll 
als Arzt. 
M. 18850. 







Gesehen zur ßegfatiblgiicg der 
2*^« stehendeu Unterachiift. 
Berlin, den ^ fe^e^t^^^ /^3S. 

Das Auswärtige,s^grtp^j : j,50 #. 
cka DeutsQ^n Reichs. 

rag: Nr. GIB. 




^R\X0^ 



^^k^i^ 



r 



n 



VISTO EN ESTE C0N8ULAD0 OET ESPAKA 
CUENP P^A MC*WZAR Ir* FIR 



AäJLv 



tUN. 



Ytl m^Mk. DE ia2^ 



V"^^^ David Carreffo 







IDERECHOS CONSULARES ESPANOLES 




^/////^ 



1 



^^.^^ 



I 



i^..; 



r 



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t. *..L 



T^.^ 



Z<jUj Jrxü^köJ DijX.-4J.tj.Ai 






^■J 






! ^ 



ü ;/lio: it :.:iv ocncer 



'JLic ir: tu c^rtifr tlii.t 3:R.ZjI;T . YLU^R,. .J..713 rarl 



.Yenuc,ilev' Ycri- ^I ,: .^•/v^' " "' 



b:ib:*-^ c-l ': ^tliGi:^ frc: T934-I94I, 



Wiiile here lie direc-lscd r. ^^necoloGical-ouftetr^-cal Clinic. ^.i i 



ef^tii.ation lie v/ds one of tlic bert .T3-neccl():-:icts jnd üü..tetricians 
in Athens. I considor iiii. an ercellani: phynician and ourjjcon. 1 
iiave had t/tj.c opoortmiity to follor' Lie üi)cr^:.tiüns and !iave .':een 



er-'cellent r(=r--ultr . 




ü. 



l.erber of tLe Acadeny /'"^^^J^^^^^^ > 

Ciiairran of the T.yprer.e ::Blt:L Council L.nd 

Ir-ofei'üoT of t].r : ndical Tacult^^ in tliB T'i 

Vcliens. 



iverc 



■r»o - T-^'- 



Athens , Z^ th C e p tenber 1146. 



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YgrpacKt iB HtX Vi i55>5e 




Verzeichnis iJber die gebrauchte 

Praxis- und Kl inikeinpichtung 
des Herrn Dp.B.Mü] ] er, 
Nürnberg, Linlenaststr. 14 



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3 ärztliche Apparate mit allem Zubehör 
(Röntgen- Dyathermie-Hoch f'requenz) 
1 Operationstisch urid 1 Untersuchungs- 
tisch mit 7ubehöp 
1 Vepbandsstof f-Stepilisatop 
1 Tnstpumentenkochep mit Z^behöp 
1 intbindunf skoff ep komplett (äpztl .Ge^rauchs- 
bestecke) 

gyn'kol. und chipuperische Instrumente 
i Schpeibtisch 
i4 Stühle 
1 Anzahl Lampen 
1 Schreibmaschine * 
eine gposse Anzahl med, Lehpbücher 
i6 Schpänke 
i3 Tische 
5 Waschständep 



2 ^app9?eils m^dical s avec aprDartprance 

(Röntgen , Dyathf>pmle,Hochf p9quenze 

1 table '1*op^patiors et ä*eramin?.tions 

avec appaptenance 

1 appapeil h Stöpiüser los bandages 

un noT^bre des appareils et 

ins' ruments 
m^dicals 



1 table ii ßcripe 

14 chaisp>3 

plusieures lampes 

1 machine k ecrire 

un grand rombpe de liv.ros m^dicals 

16 armoires 

13 tabl PS 

5 cuvettes 



eine grosse Anzahl Porzellan-Email- und ^^ grand nombre de tasses, de peans 
Qlasschalen und Flaschen ©"^ bonteil l'^s 

2 Waagen % balances 

Wasche: 

Cg jpationswäsche, Bett-Ktlchen-u.BadewäscWe '^^ grand nombre dn linr^e 

Wäsche für den Arzt und die Schwester 

SäT0.ingswäsche 

K]inikgeschirr,E3Sbestecke& Qeräte -^^s Num6reB»ses outiTs et des vaissaux 

Küchengerate ur. '!!. div, Harsl aMunaji^gegenstände P^ur la clinique 

16 Patientenbetten, komplett ig ]its co^plets pour d^s -alaips 

2 Sauglmgsbetten n 2 n n n n petit enfants 

lö Nachttische -"it den dazu gehöriger Lamnen 15 t^.bles de nuit aviec df>s lamüPi 
und Spiegel. et aes rairroirs 



Spiegi 
4 Bett-Tische 

1 Suspen sionsgcpu st 

2 Untersichungs-Khaiselongues 



4 lits conibiti^ avec d«^s tables 
un echafand a Suspension 

2 chaiselonf'Ues pour i^examiant ion 



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Haoh der glaubhaften Erklärung der Prau Liselotte Müller , 
wohnhaft in Nürnberg sind die im Yerxeldhnis aufgeführten Gegenstände 
gebraucht. Dieselben hatte seither ihr Ehemann, Herr Dr. Ernst Müller 
während seines hiesigen Aufenthaltes in seinem Gewerbebetriebe als Frauen- 
arzt in Benützung. Herr Dr. Müller ist nach Athen übersiedelt. Dort 
sollen die Gegenstände ihm in seinem Gewerbebetriebe zum eigenen Gebrauch» 



dienen* 



2&SEP.1934 



Nömbcrg, den 

Polizeidireition Hümberg^FWJi 

ICE. 



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GRIECHISCHES KONSULAT 
ZU WÜRZBURG 




WÖRZBURG. DEN 

JULIUSPROMENAOE 66 
FERNRUF 4002 



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Polize-direktion Nürnberg-Fürth. Nürnberg, den /^- J^'^^y^ \<^:^ 

Leumundszeugnis. 

Auf Grund der Erh^bunge ^. wi rd htprnlt bestätigt, daß über den 
Leumund des PrÄU.enar:^te3 

Herrn Dr, .od. ?]rr.st ^! Uli , r, 

geboren am '^^ ,^o\.r\v..r 1^33 zu Schi..ai :Mi>^ei., 
..preußlsclier Staatsangehöriger. ' *^v " 

... X « . . 

^ach in i>olitii:c:ier Losiclr-j^j 

NaohtPlllges Tiler nicht bekannt ist. 

K.E. 

Geb . Reg . Nr ^2.9 1^ ^^ ^^' ' 

Gebühr Kf^ ^..»§.4 bezahlt. 

6371. 




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Abschrift 
T-b.::r.:l/6 Eni/.7g. 

Bayer. Land es Siedlung 

..: . .j^'Srtir^ für Ausv/andererberatung 

in Verbindung mit dem 
Deutschen Ausland-Institut Stutt;::art 



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tlünciien, den 5. Juni 1934. 
Eanalstr.29/lII 



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Herr Dr. Ernst 1:1 ü 1 1 e r, Frauenarzt, wohnhaft in 
llürnberr, Lindenaststr .37, hat hier glaubhaft gemacht, daf3 er die 
ernsthafte Absicht hat, mit seiner Familie - Ehefrau vuid zwei mi>i- 
d erjährigen Hindern - nach 

Griechenland 
auszuwandern, da ei' als Ilichtarier seine Existenz nicht aufrecht 
erhalten kann, obgleich als IZri^steilnehmer zu den Ilrankenkassen 
zugelassen. 

nachdem seine vielfachen Bemühungen um Gründung einer 
neuen Existenz - zuerst in Palästina, dann in Spanien, - infolge 
unüberwindlicher Schwierigkeiten gescheitert sind, bietet sich 
ihm jetzt Gelegenheit, zusammen mit einem früheren griechischen 
Studienkollegen die Errichtung einer Privatklinik in Athen zu be- 
treiben. 

Voraussetzung hierfür ist die Ablegung des griechischen 
Staatsexamens, die erst nach zwei Jahren möglich ist, und ferner 
die Beibringung eines größeren Kapitals zur Erriclitung der Klinik. 
Hierfür und für den Lebensunterhalt der vierköpfigen Familie wäh- 
rend der liwei Jahre, wo noch kein Verdienst anfällt, bittet der 
Antragsteller um die Freigabe von PJ{ 50.000.-. 

Unter den gegebenen Verhältnissen begutachte ich den An- 
trag v;ie folgt : 

VJi 20.000.- i.Vi*. Reichsmark zwanzigtausend in bar 

PJ; 30*000.- i.V/. Reichsmark dreißigtausend in V/aren 
- deutschen Materialien und Einrichtungen für die Klinik -, wobei 
für letztere die Gev/ährung einer längeren Bezugsfrist befürwortet 
wird. 

Ferner wird mit Rücksicht auf die Dringlichkeit des Vor- 
habens empfohlen dem Antragsteller einen Betrag von ^% 15.000.- in 
bar (von den beantragten VJi 20.000.-) vorläufig gelegentlich seiner 
bevorstehenden Auswanderung zu genehmigen. 

Herr Dr. Müller hat den Krieg als Freiwilliger an der 
Front unter Auszeichnung mitgemacht und sich hierbei Beschädigungen 
zugezogen, durch die er in seiner körperlichen Betätigung behindert 

ist. Sein Gesuch verdient deshalb besondere Berücksichtigung. Auch 
v/ird durch seinen V/egzug von Nürnberg eine bedeutende Praxis für 






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einen arischen Facharzt frei. Schließlich dürfte die Errichtung 
einer guten Fachklinik unter deutscher Leitung in Griechenland 
dem Ansehen des Deutschtums dort förderlich sein. j 

Die beiden früher ausgestellten Bescheinigungen vom 5.10.33 
Tgb. Nr. 22/10 Em und vom 20.12.33 Tgb.. Ilr. 102/10 Em./v/a. ver= 
lieren hiermit ihre Gültigkeit. 



Der Devisenbewirtschaftungsstelle sind vorzulegen; 

polizeiliche Dauerabmeldung 
Einreisesichtvermerk für Griechenland 
Unbedenklichkeitsbescheinigung des Finanzamte 
Verzeichnis des in- und ausländischen Ver- 
mögens . 

Bayer. Landessiedlung 
Abteilung für Auswandererberatung 
gez. Engelhardt 



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Phof. BERNHARD ZONDEK 

JUKUHAIL.1CM 

ROO'HflOHILD HADAHSAH 
ONIVKR«lTY HOSPITAL. 



Ji^;^ ^jV^j: ^y'^ij. 






TO WHOM IT MAY CONCERN 



THIS IS TO CERTIFY thet Doctor ERNEST MYLLER 
from NEW YORK is known to me for ebout 30 years. I know 
th&t he got hls educetion st the Feul Stressmenn Gynecologicsl 
snd Obste^tricel Hospitel of the Berlin üniversity. 

Doctor Myller wss later a well known gyneoologist 
find obstetricifcn et Nuremberg in Gerraöny, fend since the time 
of the Nazi regime he has been working in Athens (Greece) 
where he had a Gynecölogical and Obstetrical Clinic of his 
own. I know that Doctor Myller had an outstending reputation 
in Athens. 

I can recommend Doctor Myller warmly es a man 
of excellent character, as a very reliable physician, and 
8 well trained gyneoologist and obstetrician. 





Bernhard Zondek. 



Jerusalem, September 22, 1946. 



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Dr. Ernest Myller, 
Gynecologist, 60 

Dr. Ernelii' Myller. sixty, a 
gynecologret and obstetrician 
with Offices at 65 E. 76th St.. 
died yesterday of a heart attack 
at his home, 450 E. 63d St. He 
was on the staff of the Post- 
Graduate and Madison Hospitals. 

In 1933 Dr. Myller, chief gyne- 
cologist. and surgeon at the 
Marthaheim Hospital in Num- 
3^rg, Germany, was driven out 
^f the country by the Nazis. He 
went to Athens where. within a 
year, he had passed the Greek 
medical examinations, though 
he had not known the language 
before his flight from Germany. 

For seven years he was head 
of a private hospital in Athens. 
In 1941, when the Nazis invaded 
Greece, Dr. Myller was rescuec 
with his family by the British 
Navy. He had been in the United 
States for twelve years. 

Dr. Myller had designed in 
struments used in the detectio., 
of Cancer in the Uterus and ap- 
paratus used for the eure of 
sterility. 

Surviving are his wife, Mrs. 
Liselotte Myller, and a son, 
Ralph Myller. Another son, Lt. 
Ulrich Myller. was killed in 
action in Korea. 



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MEMBERSHIP CERTinCATE 



31f ^ Ammrati S^ort^tg tot tift ^tulug ot ^t^rtlttg 



QII|tH \B to (Ef rttf 9 //m/ 



ERNEST MYLLER, M.D, 



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SECRETARY 



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PRESIDENT 



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EeNIKON & KAHOAIITPIAKON nANEnilTHMION 
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THl IATPIKH2 ZXOAHZ 



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Dem Kandiddten der Medizin, Herrn Ernst Müller aus 
Sehmalkalden itTh. wird hiejnit auf Antrag bestätigt, 
daß derselbe die ärztliohe Vorprüfung am 17. 7. 1913 
mit der Gesamtnote I- sehr gut Bestanden hiiit. 

V/ürzburg, den 17. November 1916, 
K. Universitäts-Syndikat. 





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Vir 



um ornatissimum 




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€ivibu8 Vniversitatis litterariae Fridericae Ouilelmae 
legitime adncriptum nomen apud facultatem medicam 



rite professum esse testamur. 



Berolini, \.X u 



mens. 




anni MDCCCCXVIL 




Decanus et Professores 

ordinis medicorum 

Yniversitatis Fridericae 

Gruilelmae. 





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.Qr.g.sjii.sc.he. Chemie. 
Physik 



Botanik 



Anatomie .1... 



.Präp.arie.rüb.unge.n . I ..Kurs 



Wlirzburg.,. .den. 11 .April . .1.91.2. 



K...U.niYe.r3itäts.-. Syndikat.. 









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Kurze Übersicht über anorganische und organische Chemie bei 



Prof .Dr. Feist 



Muskelphysi ologi e bei Prot . Dr.Dethe 



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Der Srfjulöner ift i>cri.>flii-htct, por Ablauf doh ö 3<^^*"^" "'•^'^ feiucni ^b^jaiu\c roii Mcfer Unioeri'ität 
ber 5onoiarieufrebit PciiDaltuu^ ober bcm Heftor x>o'\\ [cinent Jlufciitl^alt ZTaitrid^t 311 oiebcii, 

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ber (^trfularücrorbmijii^-«^«t-Trrt5Ftobcr I82h tinb bcr ^liirhtlarrcrorbinMiij poiii 
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QVOD FELIX FAYSTTMQVE SIT 



VNIVERSITATIS LITTERARIAE 

FRIDERICAE GVILELMAE 



R F.CTO R I'] M A G NJ FIGO 



REINOLDO 




B E R G 



THEOLOGIAE DOCTORE NEC NON IVRIS VTRIVSQVE ET PHILOSOPHIAE HONORIS CAVSA DOCTORE IN HAC VNIVERSITATE PROFESSORE 1>VBIJC0 ORI)IN\RJ() 
AVGVSTISSIMO BORVSSORVM REGl AB INTIMIS CONSISTORII CONSILIIS SOCIETATIS LITTERARIAE GOTTINGENSIS SOCIO EPISTVLARI ORDINE CRVCIS EERREVE TN 
SECVNDA CLASSE ALBO NIGRO IN VINCVLO CRVCEQVE PRO BELLI ADMINICVLIS PRAEBITA DECORATO ORDINIS REGII AQVILAE RVBRAE L\ QVARTA CLASSK 

ORDINISQVE REGII CORONAE IN TERTIA CLASSE EQVITE 



EX DECEETO GEATIOSI MEDICOEVM OIIDINIS 



PßOJIOTOß LEGITIME COKSTITVTVS 



GVILELMVS 



HIS 



MEDICINAE ET CHIRVRGIAE DOCTOR IN HAC VNIVERSITATE PROFESSOR PVBLICVS ORDINARIVS REGI A CONSILIIS MKDICIS INTIMIS CLINICI MFDICI IN RFCIO 
CARITATIS NOSOCOMIO DIRECTOR ORDINIS CRVCIS FERREAE IN PRIMA ET SECVNDA CLASSE ORDINVM RHOIORVM ET AQVILAE RVBRAE ET CORONAE IN TFI'TIA 

CLASSE MVLTORVMQVE ALIORVM ORDINVM A GEBMANARVM NATIONVM PRINCIPIBVS MANDATORVM EQVES 

FACVLTATIS MEDIPAE H. T. DECANVS 

VlllO CMISSIMO 

; ERNESTOlMVELLER ': 



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DISSBRTATIONEM LAVDABILEM LINGVA GERMANICA SCRIPTAM 



INSCJlirTAM 

ÜBER DIE TORSION DES SAMENSTRANGS 

AVCTORITATE ORDINIS EDIDIT 

D O C T O R I S M E D I C I N A E 

IMMVMTATES ET PJU\'lLE(iIA OllNAMENTA ET HONOßES 

DJE XVII. M. lANVAIill A. MDCCCCXIX 

i;iTK CONTVLIT 

COLLATAQVE 

P\ |]li( IIOC DJPLOMATE 

3IEDIC01IVM OIIDIISUS OBSlliN ATIONE COMPEOBATO 

DECLAIIAVIT 



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BEROLINI 

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IHEOLOGIAE DOCTORE NEC NON IVRIS VTRIVSQVE ET PHILOSOPHIAE HONORIS CAVSA DOCTORE IN lIAC VNl\ EIlSITxVTr: PROFESSORE PV15LICO ORDINARIO 
AVGVSTISSIMO BORVSSORVM REGI AB lUTIMIS CONSISTORII CONSILIIS SOCIKT-itxo r-ia«?orvAxi.t^« <,c-.^rx.oT;.,4sis 80Cl() ELM8TVLAUI ORDINE CRVCIS FERREAE IX 
SECVNDA CLASSE ALBO NIORO IN viNCvrP -^^«^^»^^ ^'^^'"«^^^-^ ^^^^^'^^^^^^ PRAEBITA • DKCORATO t^UDlNIS REGII VOVILAE RVBRAF IN OVARTA TF A^ST? 

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EX DECEETO GKATIOSI MEDICORVM OEDINLS 



PEOMOTOß LEGITIME CONSTITVTVS 



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DISSERTATIQNEM LAVDABILEM LINGVA GERMANICA SCIIIPTAM 

INSCRIPTAM 

ÜBER DIE TORSION DES SAMENSTRANGS 

AVCTORITATE ORDINIS EDIDIT 

DOCTORIS MEDICINAE 

IMMVNITATES ET PßlVILEGIA ORNAMENTA ET HONORES 

DIE XVII. M. JANVAIUI A. MDCCCCXIX | 

IIITE CONTVLIT 

COLLATAQVE 

PVBLICO HOC DIPLOMATE 

JllEDiooRVM ORDINIS OBSIGNATIONE COjlPßOBATO 

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I.VIPF.RATORIS GERMANOKVM BORVSSIAK REGIS 

RIX TORE 

ALBRKCHTO PENCK 

PFIILOSOPHIAE DOCTOKt: KT OKDINIS FHILOSüPHOKUM PROFESSOHE PVBL. ORD. 








Studiosns 








data dextra iurisiurandi loco legibus magistratibusqiie acaderaicis fidem oboedientiam reverentiam pollicitus 
numero civium Vniversitatis Fridericae Guilelmae Berolinensis legitime adscriptus est Cuius rei testes hasce 

Utteras sigillo Vniversitatis miiiiitas et Rectoris manu snbscriptas accepit 



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PräparierUbungen II. Kurs 
Physiologie 

Zoologie 

Topographische Anatosiie 
Anatomisches Repetitorium 
Physiologische Chemie 
Physiologie 

Topogrsiphische Anatomie 
Physiologische Übungen 

Zoologie 
Mikroskopischer Kurs 



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Dr.Schultze 
„ von Frey 



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Boveri 
Sobotta 
Lubosch 
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OUOD BONUM FORTÜiNATUMQUE ESSE lUBEAT 

DEUS OPTIMUS MAXIiMUS 
REGNANTE 

AÜGUSTISSIMO AC POTENTISSIMO REGE AC DOMINO 

DOMINO 

OTTONE 

REGE BAVARIAE 

SUB SERENISSIMO ET POTENTISSIMO DOMINO 

DOMINO 

LUITPOLDO 

PRINCIPE BAVARIAE REGIO 

REGNl BAVARIAE PROCURATORE 

CORAM 

ALMAE HUIUS REGIAE UNIVERSITATIS 

RECTORE MAGNIFICO 

GEORGIO DE SCHANZ 

nOCTORE RERUM POLITICARUM PROFESSORE ORDINARIO OECONOMIAE PUBLICAE CONSILIARIO REGNI BAVARIAE 

EQUITE ORDINIS CORONAE BAVARICAE ET ORDINIS S. MICHAELIS CL. III. 



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DEXTRA FIDEQUE DATA 

IN J.EGES MAGISTRATUSQUE ACADEMICOS OBSEQUIUM PIETATEM REVERENTIAM POLLICITUS 
EQUES HONESTATEM VITAE MORUMQUE DILIGENTER ESSE SECTATURUM PROUT INGENUUM DEGET AC LIBERALEM lUVENEM 

NUMERO CIVIUM ACADEMIAE JULIO-MAXIMILIANAE LEGITIME ADSCRIPTUS 

TESTES EIUS REI HASCE LITERAS SIGILLO UNIVERSITATIS MUNITAS 
MANUQUE RECTORIS SUBSCRIPTAS ACCEPIT. 

wircebuhgi die xjoZ'.iiensis^^^^ anni mdccccxi. 




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President 
RUDOLF NISSEN 

116 East 58th Street 

Vice- President 
JOSEPH BERBERICH 

Recording Secretary 
LOTHAR KALINOWSKY 

Corresponding Secretary 

WALTER M. FÜRST 

121 East 6 Ist Str^H 

Assistant Secretary 
HELEN O. CURTH 

Treasurer 

ARON GOLDSCHMIDT 

12 East 88th Street 

Assistant Treasurer 

ERNEST GOLD 

Archiüisl-Historian 
FELIX JACOBI 



Subalf Utrrlfom iMpöiral &onrti| 

in tljr Olilii of Nrm flnrk 



Founded 1660 
Incorpnratecl 1867 



Committee on Admission 

CHARLES GOTTLIEB 

ARTHUR ISRAEL OSCAR ULRICH 

Program Committee 

W. V. BERGER HANS R. SIELMAN 

ARTHUR SONNENFELD 

Publishing Committee 

FRANZ GROEDEL BRUNO KISCH 
MAX MILLER 

Legal Counsel 

ALBERT HIRST. Eiq. 

51 Chambers Street 



New York Academy of Medicine Building 
Fifth Avenue at I03rd Street 

Telephone. At water 9-4700 



Regulär Monthly Meeting 

Monday, January 6th, 1947 

6:30 P.M. Sharp 



A 



/. Executive Session. 

Report o( the outgoing President. 

//. Scientific Session, 

a) Demonstration: 

Ernest Myller — Problems in the Therapy 
of Sterility. ( 1 min.) 

b) Papers of the Evening : 

1 . Ernest Gold — Surgical Trealment of 
Hyperparathyroidism. (20 min.) 

2. Alexandra Adler — Neuroses in Child- 
hood. (20 min.) 



Recommended for Election: 

Louis Adler, 61 West 74t h Street 

Joshua Breuer. 851 West 18 Ist Street 

Aladar Parkas. 133 East 58th Street 

Kurt F. Fraenkel, 270 Fort Washington Avenue 

Hilde Lachmann Mosse. 108-25 72nd Avenue, 

Forest Hills, L. 1. 

Herman Moses. 262 West I07th Street 
Ludwig Schwarzschild, 514 West End Avenue 
Henry Leonhard Wittner, 200 Central Park South 



///. Executive Session. 



IV. Collation. 



Applied for Membership 
See encloaed LA*t 



_«.: 




(Stfr (Summanairaltli of masaactiuartts 

Board of Registration in Medicine 
State House. Boston 



♦ »» 



Application and Fee Received 

ADMIT APPLICANT, NUMBER ) J o^ ö ö . TO 

MAR 10 11 VZ 13 1942 
EXAMINATION AT 9.30 A.M., •^'*'^. "^V "^ * 

IN THE AUDITORIUM, STATE HOUSE, BOSTON. 

N. B. — Bring Fountain Pen 

Admission Card and Numbered 

PHOTOGRAPH. H . Qu i mby G|^lupe^ WI . D. 

2ra—(b) -1-41-479« 



Im (a)— 9-41— 7327 



)Uor^ 



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Cert. No. ..^:?^.t39 

BOARD OF REGISTRATION IN MEDICINE 

STATE HOUSE 

TEMPORARY CERTIFICATE 



M«n -|*^ 10/0 

having been examined (^1 !...". l.rlJs.ZL., and found quaUfied by 

this Board, has been registered as a qualified physician, as provided by the 
laws of the Commonwealth. 

This certificate must be exchanged for an engrossed certificate with- 
in one year as it will become void at the expiration of that time. When the 
engrossed certificate is ready, word will be sent to you from this office that 
the exchange can be made. 




Secretary 



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ORTHO RESEARCH FOUNDATION 

RARITAN, NEW JERSEY 



May 5, 1953 



Dr« !• C* Rubin 
911 Park Avenue 
New York. N. Y. 

Dear Doctor Rubin: 

We are enclosing two copies of your 
paper as corrected to the best of our knowledge« 
Possibly Dr« Myller would like one of these« 

May we take this opportunity of 
thanking you for your painstaking efforts on behalf 



of Salpix? 



We have sent a large amount of Salpix 



out and are having very favorable connient8< 

Kindest regards« 



tu V« Chapple« M« D« 



Sincerely, 



yj^ 



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Director of Clinical Research 



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excellent visualization 
simplified technique 

noni('f'ii''iri(ig and nontoKu 
painless 

no damage to tissues 
systemically safe 

'.v»ii:)("'io|iil)h .\ad cibso , 

no danger of oil embolization 

no radiopaque residue 

no foreign body granulomata 





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CONTRAST MEDIUM 



O r (f (h G 



Ortho Pharmaceutical Corporation 



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for safer hysterosalpingography 




CONTRAST MEDIUM 

Salpix contrast medium makes available for the first time for 
hysterosalpingography a radiopaque substance thot 



is nonirritating 




is painless 

leaves no radiopaque residue 

permits adäquate visualization 
of the Uterus and tubes safely 



Although long proposed as an extremely valuable diagnostic procedura' 
hysterosalpingography has not met with general acceptance because of the 
pathological and morbid sequelae so frequently found with the use of 
hitherto available contrast media.^'* 

Neither the "interrupted fractional injection"technique proposed by Hyams^ 
nor the 24-hour postinjection film, common with iodized oils, is necessary 
with Salpix contrast medium. 

Salpix contrast medium combines the blood extender polyvinylpyrrolidone^ 
with sodium acetrizoate. RV.R is stable,' nonantigenic and possesses certain 
choracteristics similar to human serum albumin^° which assert a protective 
action diverting excretion of toxic dyes and other toxins through the kidney 
rather than the liver." Sodium acetrizoate contains 65.8% iodine per mole- 
cule of the Compound and thus possesses a high degree of radiopacity. It is 
water-soluble/^ stoble, and does not release any free iodine. 



methods of use 

hysterosalpingography 

Standard gynecological procedures are followed, with the 
important exception that 24-hour postinjection films, 
common with iodized oils, are not necessary'^ followlng 
the use of Salpix contrast medium because 
of its ability to pass through the finest tubal lumen. 

QS an aid to diagnosis of uterine pothology 

Rubin'^ observed that diagnosis of uterine pothology is greatly aided 
if excess Salpix contrast medium is withdrawn from the Uterus 
via the introducing cannula. This is due to the property which Salpix 
contrast medium possesses of coating the uterine wall with a fine 
film of the radiopaque medium. 

indications for hysterosalpingography 

I Determination of tubal patency. 

2 Mechanical release of tubal obstruction. 

O Diagnosis of molformations of the Uterus or failopian tubes. 

4 Postoperative visualization of tubal piastic surgery. 

5 A diagnostic procedure as an aid in the detection of uterine 
and tubal pothology. 



controindicotions to hysterosalpingography 

I Presence of severe vaginal or cervical infections. 

2 Existing or recent pelvic infection. 

3 Pregnancy. 



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Saüfk 

M T.M. 



CONTRAST MEDIUM 

for safer hysterosalpingography 

available 

Package of 6 individual rubber-capped sterile vials, 
each vial filled to deliver 6 cc. Salpix contrast medium. 

bibliography 

I.Rubin, I. C: Röntgendiagnostik der Uterustumoren mit Hilfe von Intrauterinen Collargoliniektionen 
Zentralbl. f. Gynäk. 38:658, 1914. 

2. Wharton, L. R.: Gynecology with a Section on Femole Urology, Philadelphia, W. B. Saunders Company, 
1943. r- /' 

3. Bloomfield, A.: Six Cases of Venous Intravasation following Intrauterine Lipiodol Iniection, J. Obst & 
Gynaec. Brit. Emp. 53:345, 1946. 

4. Brown, W. E.; Jennings, A. F., and Bradbury, J. T.: The Absorption of Radiopaque Substances Used in 
Hysterosalpingography, Am. J. Obst. & Gynec. 58:1041, 1949. 

5. Eisen, D., and Goldstein, J.: Lipiodol Intravasation during Uterosalpingography with Pulmonary Com- 
plications, Radiology 45:603, 1945. 

6. Holm Nielsln, R: Injuries Caused by Hysterosalpingography, Acta obst. et gynec. Scandinav. 26:565, 
1946. 

7. Hyams, M. N.: Uterosalpingography by Interrupted Fractional Injections, Surg., Gynec. & Obst 60-224 
1935. . . , 

8. Reppe, W.; Schuster, C, and Hartman, A.: Polymerie N-Vinyl Lactams and Process of Producing Same. 
Bibliographical list published by General Aniline & Film Corporation, New York, March, 1951. 

9. Schildknecht, C. E.; Kinney, P. W., Stecker, M. L.: Periston Type Polyvinylpyrrolidone: Report on Physical 
Properties, P B Report 96884, Office of Technical Services, United States Department of Commerce. 

10. Bennhold, H., and Schubert, R.: Investigation of the Possible "Vehicie Function" of the Plasma Substi- 
tute Periston, Ztschr. f. d. ges. exper. Med. 173:722, 1944. 

11. Schubert, R.; New Method for Detoxication by Infusion of Low Molecular Fractions of Kollidon: Pre- 
liminary Report, Deutsche med. Wchnschr. 7Z:55\, 1948. 

12. Neuhaus, D. R.; Christman, A. A., and Lewis, H. B.: Biochemical Studies on Urokon (sodium 2,4,6- 
triiodo-3-acetylaminobenzoate), a New Pyelographie Medium, J, Lab. & Clin. Med. 35:43, 1950. 

13. Rubin, I. C; Myller, E., and Hartman, C. G.: Solpix: A New Approoch to the Ideal Radiopaque Medium 
for Uterosalpingography, Fertil. & Steril., in press. 

14. Rubin, I. C: Personal eommunication. 




Ortho 



Ortho Pharmaceutical Corporation 



Roriton, New Jersey 



L-12Ö 



■«■NW 



Printed in USA. 



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Salplx: A New Approach to the Ideal X-ray Opaque 

Medium for Uterosalplngography 

I, C> Rubin, M,D,, F.k.C.S., Emest Myller, M.D. and Carl Q. Hartman, PhoD 



( 



Ever slnce the first attempts were made to vlsuallze the uterine cavlty 
(hysterography) and the lumen of the f alloplan tubea (salplngography) 
by roeans of Intrauterine collargol Injectlon reported Independently by 
Wm.^Cary and I. C. Rubin In 19l4, raany Improvements have been advocated, 
Beglnnlng wlth dlfferent Solutions contalnlng halogen salts [Rubin (24)j 
Kennedy, (lla^ IIb)] there followed the development of lodlzed olls, of 
whlch Llplodol Is representatlve of the entlre group of substances com- 
blnlng lodlne wlth olls of varlous klnds . Llplodol was flrst proposed 
by Slcard and Porestier (37) for general use and by Heuser (lO) for ap- 
pllcatlon In gynecology (3, 8, 13, l4, 32, 35, 36, 40) • 

When the organlc lodlne-contalnlng Compounds such as Uroselectan, 
Hippuran and Diodrast were developed for urologlcal x-ray dlagnosls, 
many gynecologlsts soon adopted these In thelr original form or In some 
modlflcatlon thereof (ll, 12, l6, 23, 30). The newer contrast media 
comblne a water-soluble organlc lodlne Compound wlth a vehlcle to en- 
hance the vlscoslty. Among these comblnatlons may be mentloned Sklodan 
comblned wlth acacla and Rayopaque wlth polyvlnyl alcohol^ most recently 
carboxyraethyl-cellulose and dextran have been employed to Increase the 
vlscoslty In thls raanner, the last-named especlally In Sweden and 
Swltzerland. These contrast media have all had the same objectlvej 
namely, to avold leavlng oll resldue In the female genital tract. 



\ 



( lodlzed olls have been employed many tlmes by two of the present authors 

untll the deleterlous effects of the olls were dlscovered In 1927 (25, 
26) . The harmful results of lodlzed oll comblnatlons as used In the 
Investlgatlon of sterlllty may be summarlzed as follows? 



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1) Retentlon In obstructed f alloplan tubes . If the tubes have been non- 
patulous, no apparent damage Is suffered by the patlent. If, however, 
the tubes have been partlally patent, the lodlzed oil Is trapped by 
vlrtue of Its vlscosity, Its very slow absorptlon and fallure to mix 
with the tubal secretlons. Retained for varylng lengths of time wlthln 
the constrlcted lumen, the oll may, and actually does, set up a forelgn 
body reaction leading to granuloma formatlon and complete tubal ob- 
structlon. The first Observation of such oll retentlon In the falloplan 
tubes was reported by Rubin In 1927 (25) and publlshed in 1928 (26). 
Other reports of tubal Irritation soon followed (Ries (22); Novak (l8, 
19); Rubin (27, 31, 32). 

2) Multiple cyst formatlon. A second undeslrable sequel of the intra- 
uterine injection of iodized oil is the long periods of time that 
spillage Into the peritoneal cavity remain (4, 7, 17, 31, 32), setting 
up multiple cyst formations, which it is well to avoid even though such 
peritoneal reaction may not interfere with conception. 

Many gynecologists do not favor, or are unenthusiastic conceming, the 
use of iodized oil for salpingography, fearing inJury to the cilia. 

3) Oil embolism. Of less frequent occurrence (l), but more serious 
when it occurs, is the intravasation of iodized oil into the uterine 
veins and thence into the systemic circulation (l, 2, 6, 21, 42). Also 
to be reckoned with is the introduction of the oil into the myometrium, 
especially in cases of adenomyosis where the iodized oil remains for 

a long time, with or without inciting inflammatory processes . 



K 



These clinical and pathological observations have led to renewed ef- 
forts at making available an x-ray opaque substance which has the 
following properties: l) it should be dense enough to cast clean 
shadowsf 2) it should pass through the fallopian tubes slowly enough 



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( 



to be fllmedj 3) It should be sufflclently vlscous so that strlctures 
of the tubal lumen may be accurately vlsuallzed; 4) and flnally the 
materlal Injected should be resorbed wlthln a few hours, leavlng no 
trace behlnd, elther in the tubes or in the peritoneal cavlty, yet of- 
ferlng the possibillty of raaklng a complete and positive dlagnosls In a 
relative ly short tlme. In thls connectlon the now well-known fact need 
hardly be mentloned that when lodlzed olls are used, a 24-hour film Is 
Indispensable to establlsh tubal non-patency or hlgh-grade tubal strlc- 
tures. 



( 



The four crlterla have been fully met In Salplx. 



Descrlptlon 
The present paper deals wlth an x-ray opaque medium, Salplx, which is 
a comblnation of a Solution of polyvlnylpyrrolldone (PVP), basls of a 
well-known blood extender, to which has been added Sodium Acetrizoate 
CMalllnrVrpodt) The widely used blood Substitute PVP (9) has been 
selected as a suitable agent to impart to the acetrizoate, a Compound 
of high x-ray opacity, the needed viscostiy and tissue adhesiveness . 
Sodium Acetrizoate has a high iodine content (65.8j6) as may be seen 
from the following formulas 




Chemically thia Compound is described as sodium 3-acetylamino-2-4-6- 



triiodobenzoate . 



l 



Salplx is an amber colored raixturei Its viscoslty at 37^C is approx- 
imately 200 centipolse. It contains 3^^ Sodium Acetrizoate. It is 
Stahle on storage at 50^C for 6 months, and will permlt autoclaving 



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wlthout loss of Its deslrable propertles . It Is subjected to the usual 
Controls for sterlllty and pyrogenlclty. 

Historie Note 
It Is of Interest to recall that the flrst trlals wlth uterlne Injec- 
tlon of x-ray opaque substances were made upon the human female on 
purely emplrlcal grounds . Cary^s flrst Injectlons of Collargol were 
made wlthout prior anlmal experlmentatlon and Rubin had made only ana- 
tomlcal studles and Injectlons of Collargol In the rabblt before ap- 
plylng the method cllnlcally. Soon after. In preparatlon of the cllnlcal 
use of oxygen Insufflatlon through the uterus, Rubin Injected the dog's 
veln wlth an amount of oxygen equal to that recoramended for the cllnlcal 
dlagnosis of tubal patency» 

In retrospect there Is no doubt that the new venture was concerned only 
wlth the anatomlcal feaslblllty and the physlcal reallzablllty of the 
x-ray opaque agent. Untoward effects were only appreclated after some 
cllnlcal trlal wlth varlous substances eraployed In hysterosalplngography. 



( 



Thls early emplrlcal method has slnce been abandoned and replaced by 
scientific experlmental controls whlch were Instltuted for example in 
the case of viscorayopaque (Rayopaque) . Thls substance appeared to 
satlsfy the deslderata of vlscosity as well as non-resldue, but proved 
to have Irritant action, in many cases for some mlnutes and occaslonally 
longer. As the manufacture of thls product was dlscontlnued, the op- 
portunlty proferred by the Ortho Research Foundation was welcoraed to 
develop another x-ray opaque substance havlng the same deslrable 
prlnclples of Rayopaque minus its disadvantages . The blood Substitute 
polyvinylpyrrolidone as the viscoslty-renderlng vehicle for the or- 
ganlc iodine component acetrizoate has been subjected to modern ex- 
perlmental controls to determine their deslrablllty for cllnlcal trlal 



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as follows: 



( 



The Questlon of Toxiclty of PVP and 






Since the non-toxlclty of each coraponent of Salplx has been amply 
demonstrated (9, 12), and It mlght have been assumed that the combina- 
tlon of the two to be also non-toxlc, nevertheless thls was not taken 
for granted. Special tests were therefore made to study thls new con- 
trast medium, Salplx, for posslble Irritation and toxiclty. These tests 
conslsted of Injectlng It Into monkeys, rabblts, dogs and rats, In- 
travenously, Intraperltoneally by dlrect abdominal puncture and by way 
of the Uterus, also subcutaneously and by gavage . The tests are pre- 
sented In outline as follows s 

Summary of Experiments wlth Monkeys 

Thlrty experlments were made on 13 monkeys; of these anlraals two were 
used 4 tlmes; two 3 tlmes; four twlce and 8 but once . In all ex- 
perlments x-ray fllms were taken. 

Three monkeys recelved each 5 cc . of Salplx Intravenously; none showed 
the sllghtest reactlon or Symptom. In 5 experlments the uterus was 
entered and Injected froro below by the technlques of Rubin and Morse 
(29)j 6 tlmes the uterus was Injected successfully from wlthout. I.e. 
through the abdominal wall, because the approach from below Is some- 
tlraes extreraely dlfflcult. Three tlmes a laparotomy was done and the 
Uterus Injected. Nlne Intraperitoneal Injectlons were made to test 
toxiclty and rate of absorptlon. In 4, the vaglna only was Injected. 
None of the 13 monkeys showed the least sign of Irritation or toxiclty. 






Absence of Toxiclty In Dogs and Rabblts 

« 

A dog was Injected subcutaneously wlth 5 cc. of Salplx . At autopsy 
the next day, no sign of Irritation was dlscernable at the Injected 



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area. Another dog received subcutaneously 2 cc, of Salplx in each of 
these reglons: right and left scapula and rlght and left gluteal 
reglons; no reactlon was noted. A thlrd dog llcked the slte of injec« 
tlon of 5 cc. of Salplx frora tlme to tlme for about an hour, otherwlse 
showing no Symptoms • 

Pour rabblts injected with 5 cc. of Salplx Intravenously showed no 
Symptoms of dlscomfort or Irritation whatever. A flfth rabblt was 
treated as follows: 5 cc. of Salplx was Injected Intravenously; 5 
minutes later, the rlght renal pelvls and ureter and left renal pelvls 
were vlsuallzed on the x-ray film; the llver was mottled, the lobules 
belng outllned. After 30 minutes there were the same flndlngs, much 
materlal showing In the bladder. In 50 minutes, both Ureters were 
vlsuallzed, the bladder seen to be dllated and füll of Salplx. In 80 
minutes another Intravascular Injectlon of 2.5 cc. of Salplx was made. 
The flndlngs were the same as before. No Symptoms appeared. 



Rate of Absorption of Salplx 



After Intravenous Injectlon of ^ cc. in_ rabblts the materlal was 
vlslble only In the bladder one hour later. 



After Intravenous Injectlon In monkeys t 

No. 29 - 1/18/52 - 5 cc. - In one hour all Salplx In bladder 
No. 26 - 1/23/52 - Same In 75 minutes. 



( 



After Intraperitoneal Injectlon In monkeys (^ to 5 cc.)? 

No. 2 - 1/18/52 - 3 cc. - In one hour, none In body cavlty, all In 
bladder. 

No. 11 - 1/28/52 . 5 cc. - Same as #2. 

No. 8 - 1/29/52 - 5 cc. - In one hour falnt streaks of Salplx appeared 

In abdominal cavlty, bladder shadow showing large fllllng. 



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No. 30 - 2/5/52 - 3 cc. - In 80 mlnutes all In bladder. In 2k hours 
none left In bladder. 

No, 8 - 2/5/52 - 3 cc. - In 30 mlnutes none vlslble in abdomen, bladder 
fllled wlth Salpix. In 23 hours, none anywhere. 



Injectlon of uterus of inonkeys ( 3. cc . ) : 

No. 21 - 11/19/51 - In 90 mlnutes slight resldue in uterus, most in 
bladder. 

No. 8 - 1/28/52 - Uterus fllled, spillage through tube into body cavity 
In one hour abdominal cavity clear, uterlne outline good, rauch Salpix 
in bladder. 

No. 20 - 2/5/52 - 3 cc. by mistake into pelvis] then 2.3 cc. into 
Uterus. In 24 hours no Salpix left anywhere. 

No. 24 - 2/5/52 - 3 cc. injected into uterus, with escape into peri- 
toneal cavity through oviduct. In 2 hours all absorbed frora abdominal 
cavity. In 24 hours all Salpix had disappeared from body. 



No. 21 - 3A/52 - Uterus injected. Escape into peritoneal cavity 
30 mlnutes uterlne lumen well outlined, no Salpix visible in body 
cavity. 



In 



( 



Summary of Toxicity Experiments 



The observations derived from animal experiments with Salpix may be 
summarized as follows: 

1) After intravenous injectlon, Salpix rapidly leaves the blood stream 
via the kidneys. It remains in the uterlne lumen of the monkey up to 
one or two hours for reasons stated below, but spillage into the peri- 
toneal cavity is eliminated within an hour. 



2) The longer retention of Salpix in the monkey uterus as compared with 
the human uterus requires a note of explanatlon. In the macaque 
species there is in the region of the cervix uteri a colliculus which 
pushes the cervical lumen dorsally, like a ball valve, rendering the 
( . already narrow passage circuitous and the emptying of the uterus more 
difficult. It is apparent, too, that because of the obstructing col- 
liculus, Insertion of a cannula frora below is practically impossible 



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wlthout surgery. The surglcal technlque to overcome the cervical ob- 
structlon to a uterina cannula was developed by Rubin and Morse (29) o 
It consists of cutting through the lateral cervix walls and bypassing 
the colliculus. By pulling apart the cervical lips, the uterine cannula 
can then be directly inserted into the uterus and injection success« 
fully acconrplished. That the colliculus blocks the discharge of 
uterine contents has been repeatedly observed by one of the authors 
(C.G.H.) who noted that the monkey uterus is much slower to expel its 
Contents (a small dead erabryo, for example) than is the case in the 
human being. In a few clinical cases with cervical Stenosis Salpix 
was retained within the uterus for about a half-hour before it was 
evacuated. 

3) As Salpix can safely be injected intravenously, its accidental 
entry into the blood stream during and after uterosalpingography is 
unattended or followed by harmful results which are, unfortunately, 
sometimes noted after intravasation of oil into the uterine vein 
causing fat embolism. 



Clinical Observations and Evaluation 






■ m'f 



Salpix has been employed by the senior author in uterotubal injection 
on over 350 patients. The clinical use of Salpix has in his hands 
been more satiafactory than that of previously available opaque 
substances. Practically none of the patients experienced the mild to 
severe abdominal pain which attends or follows injection of iodized oils 
and Solutions of organic iodine Compounds hitherto used, including 
Rayopaque. It has been a pleasant experience to see the patients 
leave the office without the slightest discomfort after injection of 
Salpix, When other iodated Compounds were used it was necessary to 
premedicate the patients because many complained of pelvic pains and 



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other signs of peritoneal Irritation lasting from a few minutes some- 
times to a few hours . Although no permanent sequellae were noted 
after other water soluble contrast media, the immediate reactlon after 
injection was a disadvantage that needed to be overcome. 

These observations have raised the questlon of what accounts for the 
absence of subjective discomfort after Salpix. The explanation ap- 
pears to be the followingi Schubert (3^) has shown that PVP reduces 
toxicity of varlous Compounds, In the case of toxlc dyes, he observes 
PVP serves to work the dyes out of blood plasma and tissues and to 
dlvert them from the liver to the kldneys, hence hastening their 
excretion, thus actlng much like human albumln binding. The Virtual 
non-existence of toxicity of Salpix may be due to the protective 
action of PVP as well as to its rapid absorption and excretion -« 
rapid enough to reduce irritation; slow enough to enable the ex- 
amining physician to make a concluslve diagnosis of intrauterine 
lesions and of tubal patency or non-patency. It is also true that 
sodium acetrizoate is stable and gives off no free iodine, which would 
of course, cause peritoneal Irritation. 



( 



Hysterosalpingography has been employed to determine radiographically 
the proximal first point of tubal obstruction in cases which were pre- 
viously demonstrated by uterotubal insufflation to have non-patent 
tubes and where surgical restoration was contemplated. In this con- 
nection it should again be eraphasized what has been called attention 
to many tlmes before by the senior author that for the determination 
of tubal patency, non-patency and partial patency, reliance may be 
placed first and foremost upon uterotubal insufflation. For those 
who prefer to resort to hysterosalpingography as a method of diag- 
noslng tubal patency, the use of Salpix serves to reduce the hazards 



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and sequellae of x-ray opaque fluide to a mlnlraum. That Is the Chief 
^ vlrtue of thls new medium. It Is taken for granted that the physlclan 
employlng Salplx, llke many other slmllar contrast media, will have 
famlllarlzed hlmself wlth the Interpretation of the radlographlc 
plctures, the detalls of whlch cannot be entered Into here.» 

Although the major Interest In Salplx Is Its usefulness In detectlng 
Iraportant Intrauterine leslons such as polypl, submucous myomas, and 
cervlcal strlctures as well as In pre- and post-menopausal perlods, the 
presence of endometrlal Carcinoma, thls new contrast medium, Salplx, 
demonstrates at least as well as any of the lodlzed olls hltherto 
extenslvely employed for hysterosalplngography wlthout sharing thelr 
dlsadvantages (32) • These condltlons have become well known, thanks 
to Innumerable reports from all parts of the world . What Is not ap« 
f preclated Is the value of routlne hysterography as a preoperatlve 
dlagnostlc measure In myomectomy and even more Importantly In the 
dlagnosls of endometrlal Carcinoma. The former will presently be dls- 
cussed In a forthcomlng monograph; the latter was flrst suggested In a 
dlscusslon of Sheffey»s paper on mallgnancy subsequent to Irradiation 
of the Uterus for benign condltlons at the 1942 meetlng of the 
American Gynecologlcal Society and has recently been the subject of a 
special communlcatlon at the Congress at Morocco In April 1952. Slnce 
then, several cases have been encountered, one of whlch Is recorded 
he re wlth. 



♦ For the reader who deslres detalled Information on thls partlcular 
subject, reference may be made to a volume on ÜTEROTÜBAL INSUFFLATION, 
publlshed In 1947. UTEROTUBAL INSUFFLATION by I . C. Rubin. Publlshed 
by C. V. Mosby Co., St. Louis, 1947. 



( 



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Gase Report: Mrs. E. G., 43 years old, a nulllpara and nulligravida 
consulted one of the present authors (l.C.R.) November l4, 1952, with 
the complalnt of bleedlng on and off for the past year, after a two- 
year perlod of amenorrhea, whlch she considered to be her menopauseo 
On physlcal examinatlon, her uterus was found not to be appreciably 
enlarged, but a small amount of dark somewhat clotted blood escaped 
at the cervix. Several days later, when she was not bleedlng, a 
hysterogram showed raany small irregulär fllllng defects along the 
rlght border of the uterlne cavlty and especlally abiindant In the 
lower uterlne segraent (Fig. l) . The plcture was strongly suggestive 
of Carcinoma, but a positive diagnosis could not be raade on account 
of the possible presence of blood clots. A suction endometrial 
biopsy was, therefore, done immediately following the hysterogram. 
The material submitted was hydrolized. A second endometrial biopsy 
was reported as Carcinoma. The patient was operated upon by Mr. V, B. 
Green-Arraytage in London, England, December 12, 1952. A total 
hysterectomy with bilateral salpingoophorectoray was done for en- 
dometrial Carcinoma (Pig 2). 



i 



Of especial interest in this case is that two vaginal smears taken 
in New York City and examined at a Cancer detection center were re- 
ported negative and third vaginal smear taken in London was also 
reported negative. Purthermore, as the first endometrial biopsy was 
not conclusive, a second one was insisted upon because of the appear- 
ance of the hysterogram. The value of x-ray visualization with 
Salpix in this particular case needs no further comment except to 
emphasize the fact that by its aid the entire conf iguration of the 
uterine cavity is visualized and not only those areas which happen 
to be within the ränge of the suction curet. 



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SummaiTy 



( 



A new water soluble x-ray opaque medium has been descrlbed composed 
of polyvlnylpyrrolldone (PVP) wlth Sodlum Acetrlzoate and designated 
Salplx.* Thls has the deslred propertles of radlopaclty and vlscoslty - 
whlch are best sulted for hysterosalplngography. Sharing the advantages 
of lodlzed olls and none of thelr dlsadvantages, thls new contrast 
medium Is also superlor to the other water soluble comblnatlons of 
lodlne wlth vlscoslty- Increaslng substances because Its use Is un- 
attended or followed by pelvlc Irritation, Salplx possesses perfect 
tolerability, A special advantage over lodlzed olls is the pos- 
slbillty of diagnosing tubal obstruction from one x-ray exposure, 
avolding the expense and inconvenience to the patlent of a second 
exposure withln 24 hours as is necessary where lodlzed oll is usedo 
Another advantage is that withln one or at most two hours It is 
absorbed, leavlng no trace thereafter, in contrast to lodlzed olls 
whlch are frequently trapped at constrlcted polnts in the tubal lumen, 
hence causlng forelgn body granuloraa and total obstruction where only 
partlal and reroedlable obstruction was present before the hystero- 
salp Ingograph. Adequate experlmental evldence and cllnlcal experlence 
in over 350 cases in whlch Salplx was used have deroonstrated its 
nearest approach to the ideal x-ray contrast medium for use in 
hysterography per se and for hysterosalplngography. 



♦ Developed by the Ortho Research Foundation, Rarltan, N. J 



(^ 



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Figiire 1 




ffl» 



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Blbllography 

1) Bank, J., Compllcatlons of hysterosalplngography. Acta Obstet, et Qynec 
( Scand, 29t383-399> 1950. 

2) Bloomfleld, Alice, Slx cases of venous Intravasatlon followlng Intrau- 

terine Llplodol Injectlons, J. Obstet. & Qynaec. Brlt. Empire, 
53? 3^5-3^6, 1946. 

3) Brandt, P. and J. Dubols, Concluslon d'une serle de 200 hysterosalpin- 

graphles practlques pour sterlllt^. Bull. Soc • Qyn^c. et Obstet. 
1949. I. P.349. 

4) Brown, Willis E., Agnes P. Jennlngs and J. T. Bradbury, The absorptlon 

of radlopaque substances In hysterosalplngography. Am. J. Obstet. & 
Gynec, 58:1041-1052, 1949. 



( 



5) Gary, W. H., Note on deterralnatlon of patency of falloplan tubes by the 

use of collargol and the x-ray shadow. Am. J. Obstet. 69:462-464, 1914 

6) Eiser, D. and J. Goldstein, Llplodol Intravasatlon durlng uterosalpln- 

gography, Radio logy, 45:603, 1945. 

7) Plnkbelner, Hans, Hysterosalplngography wlth oll or watersoluble con- 

trast media, D. med. Wchnschr., 77:1627-1630, 1952. 

8) Prazler, C. H., The use of lodlzed rapeseed oll (camplodol) for roent- 

genographlc exploratlon. Am. Surg., 89:801, 1929. 

9) General Anlllne and Pllm Corp. P.V.P. (Polyvlnylpyrrolldone) (Book) 

New York, 1954. 

10) Heuser, C, Llplodol In the dlagnosls of pregnancy, Lancet, 2:4, 1925j 

Brlt. J. Radlology 31:110, 1926. 

11) Jefferlss, Derek, Hysterosalplngography employlng a watersoluble con- 

trast medium, J. Obstet. & Gynec. Brlt. Empire, 55:271^ 1940. 



r 



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iv 



( 



k 



IIa) Kennedy, W. T., A method of keeplng falloplan tubes open. Am. J. Obstet. 
k Oynec, 3^607, 1922, 

IIb) Kennedy, W. T., Radlography of closed falloplan tubes. Am. J. Obstet, 
& Qynec, 6:12, 1923. 

12) Malllnckrodt Chemical Works, "Professional Information", Sterile Sol- 

ution Uroken Sodium 305^ and Uroken Sodium 7056, Copyright 1952. 

13) Mathieu, Albert, Hysterosalpingography by means of iodized rapeseed 

oil. Am. J. Surg., 14:63^-636, 1931. 

14) Mathieu, Albert, Lipiodol as a diagnostic aid in fibromata of female 

genital tract. Am. J. Surg., 6:720, 1929. 

15) Morse, A. H. and I. C. Rubin, The pharmacodynamic effects of certain 

oxytocics upon tubal contractions in the rhesus monkey, Surg. Oynec. 
& Obstet., 71:620-623, Nov. 1940. 

16) Neuhaus, Dorothy, Adam J. Chris tman and Howard B. Lewis, Evaluation 

of some iodine-containing organic Compounds as x-ray contrast media, 
Proc. Soc. Exp. Biol. Med., 78:313-317, 1951. 

17) Nielsen, Pool Holm, Injuries caused by hysterosalpingography. Acta 

Obstet, k Gynec. Scand., 26:265,19^6. 

18) Novak, J., Salpingographie oder Tiibendürchblasüng, Zbl. f. Qynak., 

54:3013, 1930. 

19) Novak, J., Salpingographie und IßbendSrchblasÄng, Zbl. f. Oynak, 55sl449- 

1450, 1931. 

^0) Palmer, Allan, Lipiodol "P" for use in hysterosalpingography, Pert. 
k Steril., 3^210-216, May-June, 1952. 



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( 



( 



- 3 - 

21) Platt, Arnold, Intravasatlon of Llplodol durlng uterosalplngography, 

Ohio Med. J,, 43:821, 19^7. 

22) Ries, E., Effect of Llplodol Injectlon on the tubes. Am. J. Obstet. 8c 

Qynec, 17:728, 1929. 

23) Robecchl, E. and A. Tettl, The use of water-soluble vlscous contrast 

media for hysterosalplngography, Minerva gln/c, 4:l47-153> 1952| 
Abst. In J. Obstet. & Qynec. Brit. Emp. 59:#1564, p.917, Dec. 1952. 

24) Rubin, I. C, Roentgen dlagnosls of tumor wlth the ald of Intrauterine 

collargol Injectlons, Zbl. f. Gynak., 38:658-660, 1914. 

25) Rubin, I. C.,.Thlrteenth Meeting of the Radio loglcal Soc. of North 

Am., Dec. 1, 1927. 

26) Rubin, I. C, Diagnostic use of Intrauterine lodlzed oll Injectlon 

comblned wlth the x-rays as compared to peruterlne carbon dloxlde 
Insufflatlon, Radlology, 11:115> 1928. 

27) Rubin, I. C, Subphrenlc collectlon of Llplodol followlng Injectlon 

Into the falloplan tube. Wlth observatlons on reverse gravltatlon 
of pelvlc exudates and the genlto-phrenlc Syndrome In women. Am. J. 
Obstet. & Qynec, 31:230, 1936. 

28) Rubin, I. C, Retention of Llplodol In falloplan tubes wlth special 

reference to accluslve effect In cases of permeable strlcture, N. Y, 
State J. Med., 36:1089> 1936. 

29) Rubin, I. C. and A. H. Morse, Comparatlve value of radlopaque sub- 

stances used In uterosalplngography. Am. J. Roentgenology, 4ls527, 1939 

30) Rubin, I.e., Use of soluble x-ray opaque media In gynecology. Med. Rec . 

152:212-216, 1940. 



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. 4 . 

31) Rubin, I. C, Discusslon to Lewis C. Scheffey's papers Mallgnancy 

subsequent to Irradiation of the Uterus for benign conditions. 
Trans-Am, Qynec. Soc, 67:313^ 1942. 

32) Rubin, I. C, Utero tubal insuff lation, Mosby, St. Louis, 19^7. 

33) Rubin, I. C, Comparison of carbon dioxide and opaque media in the 

diagnosis of tubal patency, Pert. and Sterility, 3tl79> 1952. 

34) Schubert, Ren^, Ne^ie Wege der Entgiftung durch Infusion niedermolekularen 

Kollidonfraktionen, D. Med. Wchnschr., 73:551-553, 1948. 

35) Seyraour, Prances I., The importance of diagnostic uterosalpingography 

in gynecology. Med. Woman's J., Sept. 1939« 

36) Seymour, Prances I., A simple method of tubal insufflation treatment 

for sterility. Med. Woman»s J., May 3, 1938. 

37) Sicard, J. A. and J. Porestier, lodized oil as contrast medium in 

radioscopy. Bull, et mem Soc. med d höp de Paris, 46:463, 1922. 

38) Sicard, J. A. and D»Oran Solal, Accidents consecutifs au injection in- 

trauterine de Lipiodol, Bull, et M^m. Soc. Nat. de Chir., 54:1423, 1928. 

39) Weir, William C. and David R. Weir, Theröipeutic value of salpingograms 

in infertility, Pert. & Sterility, 2:5l4, 1951. 

40) Weisman, Abner I., Incidence of residual intraperitoneal iodochlorol 

after hysterosalpingography, Pert. & Sterility, 3^290, 1952. 



( 



4l) White, Margaret Moore, Erro^te in technique and Interpretation of hyster- 
osalpingography and tubal insufflation, J. Obstet. & Gynaec. Brit» 
Emp., 58:573-582, 1951. 



42) Williauis, E. R., Venous intravasation during uterosalpingography, Brit. 
J. Radiology, 17:13, 1944. 



V 



Pnjo<yiant 



FIRST WORLD CONGRESS 

ON 
FERTILITY AND STERILITY 



HENRY HUDSON HOTEL 
NEW YORK CITY 
MAY 25-31, 1953 




I.F.A. 




Sponsored by 
The International Fertility Association 

and 
The American Society for the Study of Sterility 



P^uoanjcun 






FIRST WORLD CONGRESS 

ON 
FERTILITY AND STERILITY 



HENRY HUDSON HOTEL 
NEW YORK CITY 
MAY 25-31, 1953 



I \ 









I.F.A. 




Sponsored by 
The International Fertility Association 

and 
The American Society for the Study of Sterility 



I 



OFFICERS 
American Society for the Study of Sterility 

President, Irving F. Stein 
Vice-President, John O. Haman 
Secretary, Walter W. Williams 
Treasurer, Carl Johnson 
Ass't Secretary, Herbert H. Thomas 

Directors 

M. Edward Davis 
S. Leon Israel 
Lewis Michelson 
W. T. Pommerenke 
Somers H. Sturgis 
B. Bernard Weinstein 

OFFICERS 
International Fertility Association 

President, B. Bernard Weinstein 

Vice-President, A. Campos da Paz Jr. 

Secretary-General, Carlos D. Guerrero 

Assoc. Sec'y General, Abner I. Weisman 

and 

Honorary and Active Vice-Presidents 
National Secretaries of each Nation 



CONGRESS COMMITTEES 

PROGRAM COMMITTEE 
Co-Chairmen: 

A. Campos da Paz, Jr., Rio de Janeiro, Brazil. 

S. Leon Israel, Philadelphia, Pa. 
Sub-Chairman: 

M. G. Fincher, Ithaca, N. Y. 

COMMITTEE ON ARRANGEMENTS 

Chairman: 

Abner I. Weisman, New York, N. Y. 
Chairmen of Subcommittees: 

Banquet: John O. Haman, San Francisco, Calif. 

Scientific Exhibits: Charles M. McLane, New York, N. Y. 

Clinics in New York: Clair E. Folsome, New York, N. Y.; 
Abraham Stone, New York, N. Y. 

Reception: Samuel L. Siegler, Brooklyn, N. Y. 

Welcome: J. P. Greenhill, Chicago, 111. 

Registration: Carl Johnson, New Haven, Conn.; Herbert 
Thomas, Birmingham, Ala. 

Motion Pictures: Daniel B. Roth, Teaneck, N. J. 

Public Relations: Somers H. Sturgis, Boston, Mass. 

Inaugural: A. Campos da Paz, Jr., Rio de Janeiro, Brazil. 

Information: Walter W. Williams, Springfield, Mass. 

Language Interpretation: Rita S. Finkler, Newark, N. J. 

Women Physicians: Sophia J. Kleegman, New York, N. Y. 

Latin-American Night: Aberlardo Salas G., Monterrey, Mexico 

Physicians' Wives: Mrs. Martin L. Stone, New York, N. Y. 

Chief Interpreter: Mrs. Dolores Dove, New York, N. Y. 

LIAISON COMMITTEE 

Chairman: 
W. T. Pommerenke, Rochester, N. Y. 

WORLD CONGRESS COMMITTEE OF THE 
I.F.A. AND A.S.S.S. 

B. Bernard Weinstein, New Orleans, La., President, I.F.A. 

Irving F. Stein, Chicago, 111., President, A.S.S.S. 

Carlos D. Guerrero, Mexico, D.F., Secretary-General, I.F.A. 

Walter W. Williams, Springfield, Mass., Secretary, A.S.S.S. 

CONTINENTAL COMMITTEE 

Henri Bayle, Paris, France, representing Europe. 

W. T. Pommerenke, Rochester, N. Y., representing North 

America. 
Edmundo Murray, Buenos Aires, Argentina representing 

South America. 
Samuel Rozin, Jerusalem, Israel, representing Asia. 
Bryan C. Murless, Durban, South Africa, representing Africa. 
H. Pellew, Adelaide, Australia, represenüng Australia. 



THE FIRST WORLD CONGRESS 
ON FERTILITY AND STERIUTY 

It was with a good deal of doubt and misgivings that a small 
eroup of men gathered together in a room in the Gloria Hotel in 
Rio de Janeiro, Brazil, and agreed'that an international meeting 
on fertility and sterility should be held in New York City during 
the last week of May, 1953. They realized that their embryonic 
Society was without funds, that the world had not been organized 
in the field of fertility and sterility, and that language barriers 
were sure to cause trouble. Yet, on October 18, 1951, these men 
had a vision. They simply knew that, come May, 1953, the world 
leaders in fertility and sterility would get to New York somehow. 
They knew that the First World Congress on Fertility and Sterility 
just had to come soon-and why not as soon as was possible? Why 
delay? 

The organizing committee of the International Fertility Asso- 
ciation got underway and elicited the aid of the American Society 
for the Study of Sterility. The latter Organization, though still 
young and toddling, at least had some 200 members at the time. 
The planning, thinking and activities of the two societies merged 
for the Congress. Things had to be done-and done fast. They 
had but a year and a half to plan for a world-wide meeting. 

All the struggles, heartaches and sleepless nights due to uncer- 
tainties have come and gone. The First World Congress on Fer- 
tility and Sterility is an accomplished fact. Now, we no longer need 
hold our breath-the success of the Congress is certain. 

Never before in history have so many world leaders in repro- 
duction gathered together under one roof. Never before has any 
such equally ambitious program been planned for a First Interna- 
tional Meeting. Actually, the Congress will hear 189 reports from 
investigators from every corner of the earth. Discussors number 
in the hundreds. And, never before, for any specialty international 
meeting on reproduction have almost a thousand scientists regis- 
tered and paid for their reservations in advance! 

We have made mistakes-the Congress will have its flaws-our 
planning could have been improved in spots-but in the final 
analysis, we know that you will have been pleased to be a part of 
this first history-making congress. 

We are happy to have been of service to our fellow colleagues 
of the world and to the people of the world. 

The Organizing Committee 

A. Campos da Paz, Rio de Janeiro 
S. Leon Israel, Philadelphia 
Abner I. Weisman, New York City 



I 



SPECIAL RECEPTION FOR DISTINGUISHED 
INTERNATIONAL GUESTS 

Latin — American Night 
(La Noche Latino-Americana) 

BALLROOM-HENRY HUDSON HOTEL 
New York City 

Sunday, May 24, 1953, 8:30 P.M. 

tendered by the members of the 

AMERICAN SOCIETY FOR THE STUDY OF STERILITY 

and the 

INTERNATIONAL FERTILITY ASSOCIATION 

GUEST-CHAIRMAN, ABELARDO SALAS C, M.D. 

Monterrey, Mexico 



Dress — Typical Native Costume 
(Latin American) 



By Invitation 



Music by Maurice Wolfsie and his Latin-American orchestra 



Sponsored by 
Schering Corporation 



ßnx^jcf/uun 



FIRST WORLD CONGRESS ON FERTILITY AND STERILITY 

A Congress combining the sessions of the First Congress of the 
International Fertility Association and the Ninth Annual Meeting 
of the American Society for the Study of Sterility. 

Monday Afternoon — May 25, 1953 
2:00 P.M. - Ballroom (Room A) 
THE PRE-INAUGURAL SESSION 

Introductory Remarks: 
ABNER I. WEISMAN, Chairman of Arrangements Committee 
of the Congress 

2:05 P.M. - Ballroom (Room A) 

Section l-"THE REASON FOR THE CONGRESS 
-AND THE CHALLENGE" 

Note 

The age-old problem of infertility, a problem aflfecting the wel- 
fare of civilization, is being vigorously studied in all corners of the 
World. The need to assemble students of the subject, at both 
research and clinical levels, Icd to the formation of this First 
World Congress on Fertility and Sterility. In sifting the appli- 
cation for papers to be presented to the Congress, the Program 
Committee realized that it would be impossible to discuss the 
entire body of knowledge concerning fertility involving, as it does, 
many cross-disciplines. Aware of the fact that the prmiary aim of 
the First World Congress is the corrclation of all technics and 
therapies available to the infertile couple, the Program Committee 
could not include papers devoted to related aspects of the topic 
which, arising in the natural and social sciences, affect birth rates 
and national populations. • , • j 

For this reason, certain of the more important sociologic ana 
demographic viewpoints-challenging indeed, but not part of the 
Congress proper-are presented in this Pre-Inaugural Section. Ihe 
challenges presented today Warrant thought and consideration. 

A. Campos da Paz Jr. 
S. Leon Israel 
Co-Chairmen, 

Program Committee of the Congress 



I 



Honorary Chairman: AXEL WESTMAN, Professor of Obstetrics 
and Gynecology and Director of the Department of Women's 
Diseases, Caroline Institute, Stockholm, Sweden 

Chairman: S. LEON ISRAEL, Philadelphia, Pa., U.S.A. 

Vice-Chairmen: SANTIAGO DEXEUS FONT, Barcelona, Spain 

MANUEL MATEOS FOURNIER, Mexico, D.E. 
LUTHERO VARGAS, Rio de Janeiro, Brazil 

Honorary Secretary: HERBERT CHASE SOSA, Asuncion, 

Paraguay 
Secretary: HERBERT H. THOMAS, Birmingham, Alabama, 

U. S. A. 



1. Early Ideas Regarding Infertility 

ALAN F. GUTTMACHER, Obstetrician and Gynecologist to 
the Mount Sinai Hospital, New York, N. Y. 

2. The Limits of the Earth 

FAIRFIELD OSBORN, President of The Conservation 
Foundation and of The New York Zoological Society, New 
York, N. Y. 

3. Medico-social Problems and Infertility 

ARNALDO de MORAES, Professor, Department of Gyne- 
cology, University of Brazil, Rio de Janeiro, Brazil 

Discmsants: FERNANDEZ DE ALMEIDA, Lisbon, Portugal 
SANTIAGO DEXEUS FONT, Barcelona, Spain 
FRED A. SIMMONS, Boston, Mass., U. S. A. 
L. I. SWAAB, Amsterdam, Netherlands 

4. Fertility Problems in the World Today 

ABRAHAM STONE, Director of the Margaret Sanger Re- 
search Bureau, New York, N. Y. 

Discussant: CLYDE V. KISER, Milbank Memorial Founda- 
tion, New York, N. Y. 

5. Lethal Genes as a Factor in Fertility 

ROBERT C. COOK, Managing Editor, The Journal of 

Heredity, Washington, D. C. 
Discussants: VIRGILIO FERREIRA DA COSTA, Rio de 

Janeiro, Brazil 

FRANZ J. KALLMANN, New York, N. Y. 

6. Horizons Unlimited: Problems of Infertile Couples, World 
Population Pressures and the Physiology of Reproduction 
S. R. M. REYNOLDS, Department of Embryology, Carnegie 

Institution of Washington, Baltimore, Md., U. S. A. 
Discussants: ALFREDO LOPEZ DE NAVA, Mexico, D.F. 
EDWIN M. ROBERTSON, Kingston, Ontario, Canada 



FIRST WORLD CONGRESS ON FERTILITY AND STERILITY 
THE INAUGURAL SESSION OF THE CONGRESS 

BALLROOM- HENRY HUDSON HOTEL 
NEW YORK CITY 

Monday, May 25, 1953, 8:30 P.M. 

Sponsored by 

The International Fertility Association 
The American Society for the Study of Sterility 

Chairman, Dr. A. Campos da Paz Jr. 
Rio de Janeiro, Brazil 

Addresses of Welcome: 

Dr. Irving F. Stein, President, 

The American Society for the Study of Sterility 

Dr. B. Bernard Weinstein, President, 
The International Fertility Association 

Dr. Walter W. Williams, Secretary, 

The American Society for the Study of Sterility 

Dr. Carlos D. Guerrero, Secretary-General, 
The International Fertility Association 

Order of Business: 

The Roll Call of NATIONS 

The Roll Call of OFFICIAL SCIENTIFIC 
REPRESENTATIVES 

The Roll Call of NATIONAL SECRETARIES of the IFA 

PURPOSE, AIMS AND RESOLUTIONS OF THE 
CONGRESS 



I. 



8 



OFFICIAL PROGRAM 

FIRST WORLD CONGRESS ON FERTILITY AND STERILITY 

Tuesday Morning, May 26, 1953, 8:30 A.M. 

Section ll-"CUNICAL ASPECTS OF OVARIAN PHYSIOLOGY" 

(Ballroom— Room A) 

Honoray Chairman: JUAN CARLOS AHUMADA, Titular 
Professor of Gynecology, University of Buenos Aires; Chief of 
the Gynecology Service, Hospital of Clinicas, Buenos Aires, 
Argentina 

Chairman: ERNST NAVRATIL, Graz, Austria 

Vice-Chairmen: FERNANDO DE ALMEIDA, Lisbon, Portugal 

B. BELONOSCHKIN, Stockholm, Sweden 
AMERICO STABILE, Montevideo, Uruguay 

Honorary Secretary: OSCAR AGUERO, Caracas, Venezuela 

Secretary: HERMAN I. KANTOR, Dallas, Texas, U. S. A. 



1. The Value of Vaginal Smears in Sterility 

INES L. C. DE ALLENDE, Chief of the Endocrinology Divi- 
sion, Mercedes and Martin Ferreyra Institute of Medical 
Investigation, Cördoba, Argentina 

Discussants: AMELIA ERNST, Santiago, Chile 
DIB GEBARA, Rio de Janeiro, Brazil 
EPHRAIM SHORR, New York, N. Y. 

2. Hypertrophy of the Theca Cells and Sterility 

AXEL WESTMAN, Professor of Obstetrics and Gynecology 
and Director of the Department of Women's Diseases, 
Caroline Institute, Stockholm, Sweden 

Discussant: CARL G. HARTMAN, Raritan, N. J., U. S. A. 

3. Time of Ovulation in the Menstrual Cycle 

PABLO E. BORRAS, Ex-Professor of Gynecology in the Litoral 

University and Chief of the Gynecology Service of the Spanish 

Hospital, Rosario, Argentina 

and 
RAFAEL M. PINEDA, Assistant Chief of the Gynecology 

Service of the Spanish Hospital, Rosario, Argentina 
Discussants: PER BERGMAN, Malmo, Sweden 

CARL G. HARTMAN, Raritan, N. J., U. S. A. 

A. WOLF NETTO, Rio de Janeiro, Brazil 

4. Ovulation Timing 

HERMANN KNAUSS, Head of the Department of Gynecology 
and Obstetrics in Wien-Lainz, Vienna, Austria 



5. Ovulation at or Near the Menopause 

ALBERT SHARMAN, Consulting Obstetrician and Gyne- 
cologist, Royal Samaritan Hospital for Women; Lecturer, 
Clinical Gynecology, University of Glasgow, Glasgow, Scot- 
land 

6. The Incidence of Ovulation After Ectopic Pregnancy as De- 

termined by Endometrial Biopsy 
ALVIN M. SIEGLER, From the Department of Obstetrics 
and Gynecology, State University of New York at New York 
City, College of Medicine; and Kings County Hospital, 
Brooklyn, New York 

7. Conception During the Safe Period 

CARLOS COLMEIRO-LAFORET, Gynecologist and Oste- 
trician to the Vigo Hospital, Vigo, Spain 

8. Induced Ovulation and Studies on Superfetation in Pregnant 
Rabbits 

M. SAN MARTIN, Chief of the Joint Laboratory of Genetics 
and Reproduction, National University of San Marcos, Lima, 
Peru 

8:30 A.M. 

Section lll-"CLINICAL ASPECTS OF SPERMATOGENESIS" 

(Tudor Room— Room B) 

Honorary Chairmnn: EDUARDO CASTRO, Clinical Professor 
of Urology, National University of Mexico, Chief Urologist 
Juärez and Spanish Hospitals, Mexico, D.F. 

Chairman: FRED A. SIMMONS, Boston, Mass., U. S. A. 

Vice-Chairmen: RAYMOND GROSS, Dublin, Ireland 

LEOPOLDO E. LOPEZ, Caracas, Venezuela 
JAMES K. L. CHOY, Topeka, Kansas, U. S. A. 

Honorary Secretary: ROBERT S. HOTCHKISS, New York, N. Y. 

Secretary: PAUL L. GETZOFF, New Orleans, La., U. S. A. 



I. Aspects and Prospects of Quantitative Studies on Spermato- 
genesis 
EDWARD C. ROOSEN-RUNGE, Department of Anatomy. 

University of Washington School of Medicine, Seattle, 

Washington, U. S. A. 

Discussants: WILLIAM H. MASTERS, St. Louis, Missouri, 

U. S. A. 

FRANCISCO VALDES DE VALLINA, Mexico, D.F. 

10 



i 



r 

l 



2. The Endocrine Control of Spermatogenesis 

EARL T. ENGLE, Professor of Anatomy, Columbia University, 
College of Physicians and Surgeons, New York, N. Y. 

Discussants: THALES MARTIN, Rio de Janeiro, Brazil 
R. MORICARD, Paris, France 
WARREN O. NELSON, Iowa City, Iowa, U. S. A. 

3. Pre-adolescent Hypogonadism and Infertility: A Histologie 
Study of the Maldevelopment 

CHARLES W. CHARNY, Associate in Urology, Albert 
Einstein Medical Center; Associate in Urology, Hahneman 
Hospital, Philadelphia, Pa., U. S. A. and ALFRED S. 
CONSTON and DAVID S. MERANZE, Philadelphia, Pa., 
U. S. A. 

Discussants: ADIB ANTONIO COURI, Rio de Janeiro, Brazil 
ROBERT VARGAS ZALAZAR, Santiago, Chile 
R. PALMER HOWARD, Oklahoma City, Oklahoma, U.S.A. 

4. Occupation and Male Fertility: Relation of Occupation to 
Lowered Fertility and Infertility 

EDUARDO CASTRO, Clinical Professor of Urology, National 
University of Mexico, Mexico, D.F. 

Discussants: LEOPOLDO E. LOPEZ, Caracas, Venezuela 
WALTER W. WILLIAMS, Springfield, Mass., U. S. A. 

5. Aspermatogenesis in the Guinea Pig Induced by a Single 
Injection of Homologous Testicular Material Combined with 
Paraffin Oil and Killed Mycobacteria 

JULES FREUND, M. M. LIPTON and G. E. THOMPSON, 
Division of Applied Immunology, The Public Health Re- 
search Institute of the City of New York, New York, N. Y. 

6. The Influence of Orchitis Parotidea on Spermatogenesis 
ERIC NORDLANDER, Lecturer, University, Caroline Insti- 
tute; Director of Laboratory for Male Fertility Research, 
Hospital of the Caroline Institute, Stockholm, Sweden 

7. Testicular Biopsy in Some Developmental Abnormalities of 
Puberty 

D. ANDREANI, M. MONICELLI, and C. CONTI, General 
Medical Clinic of the University of Pisa, Pisa, Italy 

8. Study of the Morphological and Histochemical Changes Pro- 
duced by Estrogens on Adult Human Testes 

FELIPE A. DE LA BALZE, Associate Professor, School of 
Medicine, University of Buenos Aires, Argentina; and R. E. 
MANCINI, G. E. BUR, and JUAN IRAZU, of the School 
of Medicine, University of Buenos Aires, Buenos Aires, 
Argentina 

11 



TUESDA Y 

8:30 A.M. 

Secfion lll-A-"SPECIAL GENERAL SESSION ON STERILITY" 

(Terrace Room— Room E) 

Honorary Chairman: EDMA ABOUCHDID, Department of 
Gynecology and Obstetrics, American Hospital, Beirut, 
Lebanon 

Chairman: INES L. C. DE ALLENDE, Cordoba, Argentina 

Vice-Chairmen: RONALD M. ALDER, Melbourne, Australia 

SAMUEL LETENDRE, Montreal, Canada 
LUIS TIRADO VELEZ, Medellin, Colombia 

Honorary Secretary: DANIEL TREVINO G., Monterrey, Mexico 

Secretary: JOHN M. CANNIS, Plainfield, N. J., U. S. A. 



1. Investigation of the Married Couple in a Sterility Clinic in 
Adelaide, Australia 

HENRY EDWIN PELLEW, Hon. Gynecologist at Royal Ade- 
laide Hospital; Hon. Obstetrician at Queen Victoria Mater- 
nity Hospital, Adelaide, Australia 

2. Simultaneous Recording of Uterine and Tubal Contractility 
and of Uterotubal Insufflation 

AMERICO STABILE, H. ALVAREZ and R. CALDEYRO- 
BARCIA, From the Departments of Obstetrics and Gynecol- 
ogy and of Physiology, of the Faculty of Medicine, Monte- 
video, Uruguay 

3. Rebound Phenomen in the Female 

ADIB ANTONIO COURI, Urologist of the Institute of Gyne- 
cology, Rio de Janeiro, Brazil 

4. Post-Coital Examination of the Vaginal Contents 

LUIS RODRIGUEZ VILLA, Professor of Clinical Pathology 
in the Graduate School of the National University of Mexico, 
Mexico, D.E. 

5. An Analysis of 475 Basal Temperature Curves in Gynecological 
Gases in Haiti 

YVONNE Y. G. SYLVAIN, Hospital of St. Francis De Sales, 
Port-Au-Prince, Haiti 

6. Sterility and Functional Anovulatory Metrorrhagia Improved 
by Diathermie Coagulation of the Endometrium 

SERGIO FUENSALIDA, University of Chile, Santiago, Chile 

12 



■ 



7. The Value of Electro-Uterography in Infertility Gases 
KURT SOKOL, Bremen, Germany 

8. Frequency of Anovulatory Cycles in the Peruvian Woman 
Complaining of Sterility 

JORGE ASCENZO C, Chief of the Consultorio-Service of 
Sterility in the Lozada Clinic, Lima, Peru 

— Consecutive Translation During this Session — 



Transactions may be ordered at the Congress at the pre- 
publication price of $21.00. Only a limited edition will be 
published. Be sure to order your copy now. Since meetings 
are being held simultaneously, it will be physically im- 
possible to hear everything that is being presented at the 
Congress. 



13 



1:30 P.M. 

Section IV-"FACTORS INFLUENCiNG SPERM-EGG UNION" 

(Ballroom— Room A) 

Honorary Chairman: R. MORIGARD, Director of the Hormone 
Laboratory of the School of Special Studies, and of the Labora- 
tory of the Gynecological Clinic of the Faculty of Medicine, 
Paris, France 

Chairman: WILLIAM H. PERLOFF, Philadelphia, Pa., U. S. A. 

Vice-Chairmen: EDMA ABOUCHDID, Beirut, Lebanon 

RODOLFO ARROYO LLANO, Monterrey, 

Mexico 
MAXIM ILO TERRAN VALLS, San Jose, Costa 
Rica 

Honorary Secretary: J. LAMBILLON, Leopoldville, Belgian 
Congo 

Secretary: MELVIN R. COHEN, Chicago, 111., U. S. A. 



1. A Possible Role of Follicular Fluid in Human Fertility and 
Infertility 

RAPHAEL KURZROK, LEO WILSON, both of the 
Morrisania City Hospital, and CHARLES H. BIRNBERG, 
Brooklyn Jewish Hospital, New York, N. Y. 

Discussants: P. M. F. BISHOP, London, England 
KARL BURGER, Murzburg, Germany 
EDMOND J. FARRIS, Philadelphia, Pa., U. S. A. 

2. Further Studies of the Potential Oxide-Reduction in Tubal 
Fecondation; Applications to Sterility by the Study of the 
Reduction of Methylene Blue by Human Spermatozoa 

RENE MORIGARD, Director of the Hormone Laboratory of 
the School of Special Studies; and Director of the Laboratory 
of the Gynecological Clinic of the Faculty of Medicine, Paris, 
France 

Discussants: W. T. POMMERENKE, Rochester, N. Y., U. S. A. 
G. HELLINGA, Amsterdam, Netherlands 

3. Peritoneal Factor in Sterility 

EDMUNDO G. MURRAY, Docente Libre in Gynecology, 
University of Buenos Aires; President of the Argentine 
Society for the Study of Sterility, Buenos Aires, Argentina 

Discussants: AFRANIO A. MATOS, Rio de Janeiro, Brazil 
IRVING F. STEIN, Chicago, 111., U. S. A. 
DELFINO GALLO, Guadalajara, Mexico 

14 



. « 






I 



4. Spermigration in the Female Genital Tract 

EDUARDO BUNSTER M., Professor of Gynecology, Uni- 
versity of Chile; Chairman of the Chilean Obstetrical and 
Gynecological Society; and CARLOS LUND, and RENATO 
BENEZET, both of the Gynecological Section of the Hospital 
del Salvador, Santiago, Chile 



3:45 P.M. 

Sectio.^ V-"ENDOCRINE FACTORS" 
(Ballroom— Room A) 

Honorary Chairman: SUBODH MITRA, Professor-in-charge, 
Department of Obstetrics and Gynecology, R. G. Kar Medical 
College; Director of the Chittaranjan Cancer Hospital, Cal- 
cutta, India 

Chairman: E. C. HAMBLEN, Durham, N. C, U. S. A. 

Vice-Chairmen: JOSEPH G. ASHERMAN, Tel-Aviv, Israel 

MAURICIO TEICHHOLZ, Rio de Janeiro, 

Brazil 
G. TESAURO, Naples, Italy 

Honorary Secretary: KANJI KIKA, Sendai, Japan 

Secretary: IRVING I. KURLAND, Brooklyn, N. Y., U. S. A. 



1. Influence of Vitamin E on the Placenta 

B. S. TEN BERGE and RICHARD POLAK, Department of 
Gynecology and Obstetrics, State University, Groningen, 
Netherlands 

Discussants: U. J. SALMON, New York, N. Y. 
EVAN V. SHUTE, London, Canada 

2. The Value of Hormone-Analysis in Male and Female Sterility 
L. I. SWAAB, Leader of Central Sterility Clinic of N.V.S.H.; 

Consulting Gynecologist, C.I.Z. Hospital, Amsterdam, 
Netherlands 

3. Artificial endometrial cycles in the Ovariectomized Woman: 
Criteria of Relative Estrogenic Excess 

JACQUES FERIN, Lecturer at the University of Louvain, 
Louvain, Belgium 

4. Congenital Sexual Anomalies 

W. O. THOMPSON, Clinical Professor of Medicine, University 
of Illinois College of Medicine, Chicago, 111., U. S. A. 

15 



5. Observations on the Incidence of Congenital Anomalies and 
Their Prevention 

EVAN B. SHUTE, Medical Director of the Shute Institute, 
London, Canada 

6. The Role of the Prostate Gland in Hormone Stimulation 
JOSE ALVAREZ LLERENA, Department of Urology, Mexico, 

D.F. 

7. Contribution to the Treatment of Sterility by Hormonal Pelvic 
Vaccination 

ARMANDO NASCIMIENTO, JR., Rio de Janeiro, Brazil 



We are grateful to the International Business Machines 
Co., for their very kind Cooperation and their generosity 



in making available the hearing devices. 



16 



TUESDAY 

1:30 P.M. 

Section VI-"PATTERNS AND EVALUATION OF SEMEN" 

(Tudor Room— Room B) 

Honorary Chairman: WALTER W. WILLIAMS, Clinical Gene- 
ticist, Springfield Hospital, Springfield, Mass.; Secretary, 
American Society for the Study of Sterility, Springfield, Mass., 
U. S. A. 

Chairman: CHARLES W. CHARNY, Philadelphia, Pa., U. S. A. 

Vice-Chairmen: ERIC NORDLANDER, Stockholm, Sweden 

SERIF CANGA, Ankara, Turkey 
BASIL MAROULIS, Athens, Greece 

Honorary Secretary: LUIS RODRIGUEZ VILLA, Mexico, D.F. 

Secretary: ARTHUR A. ROTH, Cleveland, Ohio, U. S. A. 



1. An Analysis of Human Male Fertility 

JOHN MACLEOD, Associate Professor of Anatomy, Cornell 

University Medical College, New York, N. Y. 
Discussant: EDUARDO CASTRO, Mexico, D.F. 

2. Fluctuating Male Fertility 

RAYMOND G. GROSS, Physician in Charge, Infertility Clinic, 
Rotunda Hospital; Gynecologist, Bon Secour Hospital, 
Dublin, Ireland 

Discussants: CHARLES W. CHARNY, Philadelphia, Pa.. 

U. S. A. 

RUY GOYANNA, Rio de Janeiro, Brazil 

3. Electronmicroscopy of Human Spermatozoa 

MEYER D. SCHNALL, Gynecology Department, Mount Sinai 

Hospital, New York, N. Y. 
Discussant: RICHARDT H. HAMMEN, Copenhagen, Den- 

mark 

4. The Value of Urethrography in the Study of Male Fertility 
and Sterility 

M. LEOPOLD BRODNY, Urologist to the Fertility Clinic of 
Beth Israel Hospital, Boston, Mass., U. S. A. 

Discussant: OCTACILIO GUALBERTO, Rio de Janeiro, 
Brazil 

5. Evaluation of Different Seminal Patterns: their Relation to 
Clinical and Laboratory Data; their Significance with Regard 
to Therapy 

G. HELLINGA, Endocrinologist of the Ned. Herv. Diaconessen 
Inrichting, Amsterdam, Netherlands 

17 



TUESDA Y 

6. Hyaluronidase in Sterility 

MICHEL TURPAULT, Vice-President of the French Gyne- 
cological Society, Paris, France 

7. The Differentiation Between Lack of Motility and Necro- 
spermia in Human Spermatozoa; Relation to Fertility 

NORBERT KLUEKEN, From the Dermatological Clinic of 
the University of Cologne, Krefeld, Germany 

8. The Enzymatic Aspect of Male Human Fertility 

LOUIS J. CELLA, JR., From the Department of Surgery, 
Rhode Island Hospital, Providcnce, Rhode Island, U. S. A. 

8:30 P.M. 

Section VII-"CLINICAL RECOGNITION OF OVULATION" 

(Baliroom— Room A) 

Honorary Chairman: H. DE WATTEVILLE, Professor of Gyne- 
cology and Obstetrics, Faculty of Medicine of Geneva, Geneva, 
Switzerland 

Chairman: JUAN WOOD, Santiago, Chile 

Vice-Chairmen: ERNESTO DE ARAGON. Havana, Cuba 

NORMANDO ARENAS, Buenos Aires, 

Argentina 
EVAN V. SHUTE, London, Ontario 

Honorary Secretary: ELIPHALET WEIZBARD, Rishon-Le-Zion, 
Israel 

Secretary: LEONARD F. CINER, New York, N. Y. 



1. Changes in Respiratory Physiology as a Criterion of Ovulation 

W. T. POMMERENKE, R. L. GOODLAND, and J. G. 
REYNOLDS, University of Rochester School of Medicine 
and Dentistry, Rochestcr, N. Y., U. S. A. 

Discussants: CARLOS NOUEL, Caracas, Venezuela 
SOMERS H. STURGIS, Boston, Mass., U. S. A. 
JOSE MEDINA, Sao Paulo, Brazil 
ALICE NETTER LAMBERT, Paris, France 

2. Culdoscopy in the Diagnosis of Ovulation and Ovum Migration 

ALBERT DECKER, Clinical Professor of Gynecology and 
Obstetrics, New York Polyclinic Medical School and Hos- 
pital; Associate Clinical Professor of Gynecology and Ob 
stetrics, New York Medical College, New York, N. Y. 

18 



TÜESDA y 

Discussants: RAOUL PALMER, Paris, France 
JOHN ROCK, Boston, Mass., U. S. A. 
MANUEL URRUTIA RUIZ, Mexico, D.F. 

3. The Accuracy of Endometrial. Dating: A Correlation of 
Endometrial Dating with Basal Body lempcrature and Menses 
ROBERT W. NOYES and JOHN O. HAMAN, From the 

Department of Obstetrics and Gynecology, Stanford Uni- 
versity School of Medicine, San Francisco, Cal., U. S. A. 
Discussants: CHAUNCEY J. PATTEE, Montreal, Canada 
SAMUEL L. SIEGLER, Brooklyn, New York 
ALEJANDRO POU-DE-SAN 11 AGO, Montevideo, Uruguay 
G. TESAURO, Naples, Italy 

4. Hormone Effects on Basal Body Tcmperaturcs and Menstrual 
Patterns 

ROBERT M. PERLMAN, Director, Institute of Endocrinology 
and Gerontology, San Francisco, Cal., U. S. A. 

Discussants: M. EDWARD DAVIS, Chicago, 111., U. S. A. 
S. LEON ISRAEL, Philadelphia, Pa., U. S. A. 

5. Correlation Between Vaginal Cytology and Basal Tempera tures 
During the Menstrual Cycle 

INES L. C. DE ALLENDE and O. ORIAS, The Mercedes and 
Martin Ferreyra Institute of Medical Research, Cordoba, 
Argentina 

6. The Value of Basal Temperatures and Colpocyclogram in the 
Diagnosis of Ovulation 

HECTOR ROCAMORA and F. LEON BLANCO, University 
of Havana, Havana, Cuba 



Visit the Technical Exhibits on the Second Floor 



19 



WEDNESDAY 

8:30 A.M. 

Section VIII-"TREATMENT OF ANOVULATION" 
(Ballroom— Room A) 

Honorary Chairman: S. R. M. REYNOLDS, Department of 
Embryology, Carnegie Institution of Washington, Baltimore, 
Md., U. S. A. 

Chairman: SOMERS H. STURGIS, Boston, Mass., U. S. A. 

Vice-Chairmen: ZARE ARSLANIAN, Aleppo, Syria 

C. L. JHAVERl, Bombay, India 
HALIT KAMGOZEN, Ankara, Turkey 

Honorary Secretary: LYMAN W. MASON, Denver, Colorado, 
U. S. A. 

Secretary: THOMAS D. EFSTATION, Tiffin, Ohio, U. S. A. 



1. The Treatment of Female and Male Infertility by X-Ray 
Therapy 

IRA I. KAPLAN, Clinical Professor of Radiology, N.Y.U.— 

Bellevue Medical Center, New York, N. Y. 
Discussant: CHARLES MAZER, Philadelphia, Pa., U. S. A. 

2. Further Studies on the Hormonal Changes Following Low 
Dosage Irradiation of Pituitary and Ovaries in Avulatory 
Women 

ABRAHAM E. RAKOFF, Clinical Professor of Obstetric and 
Gynecologic Endocrinology, Jefferson Medical College, 
Philadelphia, Pa., U. S. A. 

3. X-Ray Therapy in the Treatment of the Menstrual Anovula- 
tory Cycle 

ADOLFO JASSIN, Chief of Gynecology of the Regional's In- 
stitute of Endocrinology, Buenos Aires, Argentina 

4. Anovulatory Cycles and Stimulant Roentgen therapy in 100 
Peruvian Sterile Couples 

JORGE ASCENZO, Chief of the Sterility Consultorio of the 
Lozada Clinic of Lima; Assistant Professor and Chief of 
Clinic of the Maternity School of Lima, Lima, Peru 

5. Induction of Ovulation in Hirsute, Amenorrheic Women 
ROBERT G. GREENBLATT, Professor of Endocrinology, 

Medical College of Georgia, Augusta, Ga., U. S. A. 

6. The Gonadotropins in the Treatment of the Anovulatory Cycle 
CESAR A. BREA, Professor of Gynecology, University of 

Buenos Aires, Buenos Aires, Argentina 

20 



WEDNESDAY 

8:30 A.M. 

Section IX-"MALE THERAPEUTIC ASPECTS" 
(Tudor Room— Room B) 

Honorary Chairman: LEWIS MICHELSON, Emeritus Associate 
Professor of Clinical Urology, Stanford University School of 
Medicine, San Francisco, Cal., U. S. A. 

Chairman: M. LEOPOLD BRODNY, Boston, Mass., U. S. A. 

Vice-Chairmen: VICTOR CONILL SERRA, Barcelona, Spain 

G. HELLINGA, Amsterdam, Netherlands 
RICHARDT HAMMEN, Copenhagen, 
Denmark 

Honorary Secretary: M. CARDIA, Lisbon, Portugal 

Secretary: LOUIS PORTNOY, New York, N. Y. 



1. Diagnosis of the Blockage of the Epidiymal Canal, the Vas 
and Ejaculatory Ducts 

ARMANDO TRABUCCO, Alvear Polyclinic of Buenos Aires, 

Argentina 
Discussants: VINCENT J. O'CONOR, Chicago, 111., U. S. A. 

A. FIGUEIREDO BAENA, Rio de Janeiro, Brazil 

2. Surgical Correction of Male Sterility 

VINCENT J. O'CONOR, Professor and Head of the Depart- 
ment of Urology, Northwestern University Medical School, 
Chicago, 111., U. S. A. 

Discussants: ROBERT S. HOTCHKISS, New York, N. Y. 
LEWIS MICHELSON, San Francisco, California 

3. Human Male Sterility due to Brucellosis: A Clinical, Histo- 
logical and Hormonal Study in 16 Cases 

FELIPE A. DE LA BALZE, Associate Professor, School of 
Medicine, University of Buenos Aires; and R. E. MANCINI, 
F. ARRILLAGA. G. E. BUR and E. A. MOLINELLI, of 
the School of Medicine, University of Buenos Aires, Ar- 
gentina 

4. Therapeutic Experiences in the Treatment of Delayed Male 
Puberty 

D. ANDREANI, and C. CONTI, Clinica Medica, University 
of Pisa, Pisa, Italy 

5. Testosterone Therapy in Male Infertility: Effect of Local 
Implantation and Intramuscular Injection 
RICHARDT HAMMEN, Copenhagen, Denmark 



WEDN ESDAY 

6. The End Results of Testostcrone Therapy (Rebound Phenom- 
enon) as Observed by the Gynecologist 

MORTIMER S. WEINSTEIN, Clinical Assistant Visiting 
Gynecologist and Obstetrician, Metropolitan Hospital, New 
York, N. Y. 

7. Incidcnce of the Male Factor as the Cause of Marital Sterility 
in Peru 

JORGE ASCENZO, Chief of the Consultorio-Service, Clinica 
Lozada, Lima, Peru 

1:30 P.M. 

Section IX-A-*'SPECIAL MOTION PICTURE SESSION OF NEW 
DIAGNOSTIC TECHNIQUES AND TREATMENT*' 

(Ballroom— Room A) 

1:30 P.M. 

•RECENT ADVANCES IN DIAGNOSIS AND THERAPY OF 

INFERTILITY" 

(Ballroom Foyers) 

An opportunity is offered on this afternoon to visit the scientific 
exhibits of the Congress at leisure and to discuss particular aspects 
of each exhibit with demonstrators at the exhibit Stands. 

1:30 P.M. 

"NEW INSTRUMENTS, BOOKS, MEDICAMENTS AND 
PHARMACEUTICALS IN STERILITY PRACTICE" 

(Second Floor Corridors) 

An opportunity to visit with the technical exhibitors who are 
displaying the latcst apparatuscs, technical aids, drugs and other 
items related to sterility practice, is provided. It is suggested that 
adequate time be allotted from your busy schedule at the Congress 
to visit these technical shows to be informed of the latest advances 
from the technical aspect of sterility and fertility. These exhibitors 
have been carefully selected and invited to participate in the 
Congress, so that you may see, collected together, in a few moments, 
what would take hours of visiting elsewhere. 



\ 



2Z 



WEDNESDAY NIGHT 

8:30 P.M. 

Section X-"THE HOSTILE CERVIX" 
(Ballroom— Room A) 

Honorary Chairman: W. T. POMMERENKE, Associate Professor 
of Obstetrics and Gynecology, University of Rochester School 
of Medicine and Dentistry, Rochester, N. Y.; National Secretary 
for the United States of America to the International Fertility 
Association 

Chairman: J. P. GREENHILL, Chicago, 111., U. S. A. 

Vice-Chairman: J. FERIN, Louvain, Belgium 

DEBORA JOFFE, Johannesburg, Union of 

South Africa 
G. L M. SWYER, London, England 

Honorary Secretary: DELFINO GALLO, Guadalajara, Mexico 

Secretary: WILLIAM T. BLACK, Memphis, Tenn., U. S. A. 



1. The Role of Endocervicitis in Sterility 

RANDOLPH GEPFERT, Assistant Professor of Clinical Ob- 
stetrics and Gynecology, Cornell University Medical College; 
Associate Attending Obstetrician and Gynecologist, New 
York Lying-In Hospital 

Discussants: DONATO RAMIREZ, Mexico, D.E. 
MARGARET MOORE WHITE, London, England 

2. Surgical Treatment of Cervical Sterility 

RAUL M. CHEVALIER, Chief of the Sterility Center, Faculty 
of Medical Sciences of Buenos Aires; Attending Physician, 
Hospital of Clinicas, Buenos Aires, Argentina: and JOSE 
M.E. MEZZADRA, Associate Professor of Gynecology, Uni- 
versity of Buenos Aires; Sub-Chief of the Sterility Center, 
Faculty of Medical Sciences, Buenos Aires, Argentina 

Discussants: LUIS GOMEZ-DAZA, Mexico, D.E. 
JULIO M. MORALES, Asuncion, Paraguay 
AURELIO MONTEIRO, Rio de Janeiro, Brazil 

3. Post-Coital Examination: Its Value and Interpretation 
RAOUL PALMER, Chief of Gynevology, Faculty of Medicine, 

Paris, France: and ELISABETH PALMER, Paris, France 
Discussants: JOSE GONZALEZ GUERRERO, San Salvador, 
El Salvador 
JOSE NEMIROVSKY, San Paulo, Brazil 
LUIS RODRIGUEZ VILLA, Mexico, D.F. 

23 



WEDNESDAY NIGHT 

4. The Crystallization Phenomena of the Cervical Mucus: Obser- 
vations with the Phase Contrast Microscope 

A. CAMPOS DA PAZ JR., Vice-President of the International 
Fertility Association, President of the Brazilian Society for the 
Study of Sterility, Rio de Janeiro, Brazil: and L. COSTA 
LIMA, Titular Member of the Brazilian Society for the Study 
of Sterility, Rio de Janeiro, Brazil 

Discussants: B. BELONOSCHKIN, Stockholm, Sweden 
FRANCE MORICARD, Paris, France 
MAXWELL ROLAND, New York, N. Y. 

5. Our Experience with the Crystallization Test of the Cervical 
Mucus 

CARLOS NOUEL, Assistant Professor of Clinical Obstetrics, 
Central University of Venezuela, Caracas, Venezuela 

6. Contribution to the Study of the Cervical Mucus in Sterility 

R. GANDOLFO HERRERA, Professor of Gynecology, Uni- 
versities of Buenos Airts and Eva Peron; and VICENTE 
LUIS BEARZI, Head of Sterility Center of Eva Peron Uni- 
versity, Head of Gynecology Service of Phthisiology Institute, 
Buenos Aires, Argentina 

7. Some Results in Cervical Mucus Crystallization 

ALEJANDRO POU-DE-SANTIAGO, Assistant at the Gyne- 
cology and Obstetric Clinica, Gynecologist of the Institute 
of Endocrinology, Montevideo, Uruguay 

8. Cytologie Cycle of the Endocervical Mucus 

AMALIA ERNST, and ALBERTO GUZMAN, From the De- 
partment of Obstetrics and Gynecology, University of Chile, 
Santiago, Chile 

9. Spermatic Findings in the Post-coital Cervical Contents 

LUIS RODRIGUEZ VILLA, Professor of Clinical Pathology 
of the Post-Graduate School of the National University of 
Mexico, Mexico, D.E. 



IHURSDAY 



" 



24 



8:30 A.M. 



Section XI-"BLOOD INCOMPATIBIUTY AND FERTILITY'* 

(Ballroom— Room A) 

Honorary Chairman: EDWIN M. ROBERTSON, Professor and 
Head of the Department of Obstetrics and Gynecology, School 
of Medicine, Queen's University, Kingston, Ontario, Canada 

Chairman: CARL E. JOHNSON, New Haven, Conn., U.S.A. 

Vice-Chairmen: JORGE ASCENZO, Lima, Peru 

LORNA LLOYD-GREEN, Melbourne, Australia 
ABELARDO SALAS G., Monterrey, Mexico 

Honorary Secretary: MAKOTO TAYA, Tokyo, Japan 

Secretary: RICHARD A. STREET JR., Vicksburg, Miss., U. S. A. 



1. Treatment of the Pregnant Woman "Iso-sensitized" to the Rh 
Factors 

MANUEL LUIS PEREZ, Professor of Clinical Obstetrics of 
the School of Medicine, University of Buenos Aires, Argentina 

Discussants: OSCAR AGUERO, Caracas, Venezuela 
J. MILTON SINGLETON, Kansas City, Mo., U.S.A. 
RAUL BRIQUET, San Paulo, Brazil 

2. Is there a relationship Between Spontaneous Abortion and 
Blood Factors? 

HARRY WALLERSTEIN, Attending in Hematology, Jewish 
Memorial Hospital; Consultant Hematologist, Morrisania 
City Hospital, New York, N. Y. 

3. A-B-O Blood Croups and Rh Subtypes in Sensitized and Non- 
Sensitized Rh-negative Pregnant Women 
ALEXANDER S. WIENER, Division of Immunohematology 

of the Jewish Hospital o£ Brooklyn, N. Y.; RAFFAELE 
NAPPI, the Clinica Ostetrica e Ginecologia Universita di 
Napoli (Direttore, Prof. G. Tesauro); and EVE B. GOR- 
DON, of the Serological Laboratory of the Office of the Chief 
Medical Examiner of the City of New York 

4. Rh Factor and Double Fetal Malformations 

JACOBO ROSENVASSER and MIGUEL MARGULIES, 
Buenos Aires, Argentina 

25 



THURSDAY 



10:45 A.M. 



Section XII-"PERINATAL MORTAUTY" 
(Ballroom— Room A) 

Honorary Chairman: EDMUNDO MURRAY, Docent Libre in 
Gynecology, University of Buenos Aires; President, Argentine 
Society for the Study of Sterility, Buenos Aires, Argentina 

Chairman: SAMUEL M. DODEK, Washington, D. C, U.S.A. 

Vice-Chairmen: RONALD M. ALDER, Melbourne, Australia 

RODULFO CAMERO, Bogota, Colombia 
LIVIA ESCALONA, Caracas, Venezuela 

Honorary Secretary: J. LAVERGNE, Panama City, Panama 

Secretary: S. S. ROSENFELD, New York, N. Y. 



1. Causes of Perinatal Deaths 

PEDRO A. GUTIERREZ ALFARO, Ministro de Sanidad y 
Asistencia Publica, Republic of Venezuela; Chief Obstetri- 
cian, Concepciön Palacios Maternity, Caracas, Venezuela 

Discussant: JORGE ASCENZO, Lima, Peru 

2. Perinatal Death 

J. M. MONIZ ARAGAO, Hospital Pro Matre, Rio de Janeiro, 
Brazil, H. FRANC DE FARIA, Rio de Janeiro, Brazil 

3. Mortality in Prematurity 

GUILHERME DE FREITAS PENTEADO and LUIZ 
ALFREDO CORREA DA COSTA, Rio de Janeiro, Brazil 

4. Fetal Morbidity and Mortality in Obstetrical Analgesia: A 
Study of the Relative Value of the Combination of Mepiridine 
(Demerol), Scopolamine, "Trilene" and Pudendal Block 

LUIZ DE FREITAS GUIMARAESE, JR, Head of the Obstet- 
rical and Gynecological Department of the Polyclinic Hos- 
pital of Botafogo, Rio de Janeiro, Brazil 

5. Social Factors Causing Prematurity 

S. DEXEUS FONT, Director of the Provincial Maternity Hos- 
pital of Barcelona, Barcelona, Spain 

26 



I 



IHURSDAY 



. 



8:30 A.M. 



Section XIII-"PELVIC TUBERCULOSIS AND INFERTIUTY" 

(Tudor Room— Room B) 

Honorary Chairman: l. C. RUBIN, Consulting Gynecologist 
Mount Sinai Hospital, New York, N. Y. 

Chairman: ALBERT SHARMAN, Glasgow, Scotland 

Vice-Chairmen: TOMAS ARMSTRONG, Havana, Cuba 

GUSTAVO ISAZA MEJIA, Medellin, Colombia 
OSBERTO ROSALES M., Guatemala City, 
Guatemala 

Honorary Secretary: JUAN A. NUNEZ, Colon, Panama 

Secretary: CHARLES R. FREED, Denver, Colorado, U.S.A. 



1. The Importance of the Specific Cultures of Uterine and Vaginal 
Discharges in the Detection of Genital Tuberculosis in Sterile 
Women 

L HALBRECHT, Director, Maternity Hospital, Hadera, Israel; 
Chairman, Board of Directors Postgraduate Medical School 
of the Kupat Holim, Hadera, Israel 

Discussants: I. C. RUBIN, New York, N. Y. 

MARGARET MOORE WHITE, London, England 

2. The Diagnosis of Tubal Tuberculosis with Special Reference 
to X-Ray Diagnosis 

SAMUEL ROZIN, Consultant, Obstetrical and Gynecological 
Department, Hadassah University Hospital, Jerusalem, Israel 

Discussants: ARIS TOBULO CARRIZO, Panama City, Pan- 
ama 
KANJI KIKA, Sendai, Japan 
JUAN WOOD, Santiago, Chile 

3. Tuberculosis of the Female Genitalia Related to Fertility 

KANJI KIKA, Assistant Professor of Obstetrics and Gynecology, 
School of Medicine, Sendai, Honshu, Japan 

Discussant: GEORGE BLINICK, New York, N. Y. 

4. The Problem of Sterility in Female Genital Tuberculosis 
ARTURO ACHARD, Docent Libre in Gynecology and Obstet- 
rics of the Faculty of Medicine; Medical Chief of the Service 
of Gynecology and Obstetrics for Tuberculosis, Montevideo, 
Uruguay 

27 



THURSDAY 

5. The Diagnosis of Tubal Tuberculosis 

MARGARET MOORE WHITE, Gynecologist to Fertility De- 
partment, Royal Free Hospital, London, England 

6. The Non-Surgical Treatment of Pelvic Tuberculosis 
LINTON MORRIS SNAITH, Senior Obstetrician and Gyne- 
cologist, Newcastle General Hospital; Lecturer in the De- 
partment of Obstetrics and Gynecology, King's College, 
University of Durham, Newcastle, England 

1:30 P.M. 
Section XIV-"DIAGNOSIS OF FALLOPIAN TUBE OCCLUSION" 

(Ballroom^Room A) 

Honorary Chairman: ARNALDO DE MORAES, Professor of 
Gynecology and Head of the Department, University of Brazil; 
Director, Institute of Endocrine Gynecology, Rio de Janeiro, 
Brazil 

Chairman: PENDLETON TOMPKINS, San Francisco, Cal., 
U. S. A. 

Vice-Chairmen: FRANCISCO LUQUE, Madrid, Spain 

JULIO M. MORALES, Asuncion, Paraguay 
CARLOS NOUEL, Caracas, Venezuela 

Honorary Secretary: ARISTOBULO CARRIZO V., Panama City, 
Panama 

Secretary: GEORGE SPECK, Arlington, Va., U. S. A. 



1. Interpretation of Manometric Oscillation Observed During 
Uterotubal Insufflation 

AMERICO STABILE, Titular Professor of Obstetrics and 
Gynecology of the Faculty of Medicine, Montevideo, Uruguay 

Discussants: L. BONNET, Paris, France 
EDUARDO BUNSTER, Santiago, Chile 
I. C. RUBIN, New York, N. Y. 

2. Tubo-ovarian Physiology: Further Observations by Culdotomy 
JOSEPH B. DOYLE, Department of Obstetrics, Tufts Medical 

School, Boston, Mass., U. S. A. 
Discussants: CHARLES L. BUXTON, New York, N. Y. 
AXEL WESTMAN, Stockholm, Sweden 

28 



IHURSDAY 

3. Uterotubal Dynamics 

CARLOS D. GUERRERO, Professor of Gynecology, Medical 
and Postgraduate Schools, National University of Mexico; 
Gynecologist in Charge of Fertility Clinic, Hospital of Gyne- 
cology in the "Mexican Institute of Social Security"— Mexico, 
D.F. 

Discussants: CLARICE AMARAL FERREIRA, Rio de Ja- 
neiro, Brazil 
PEDRO A. FIGUEROA CASAS, Rosario, Argentina 
J. P. GREENHILL, Chicago, 111., U. S. A. 

4. The Volumetrie Index of Uterotubal Insufflation 

OSCAR BLANCHARD, Associate Professor of Clinical Gyne- 
cology, University of Buenos Aires; Chief of the Gynecology 
Clinic of the J. Fernandez Polyclinic Hospital, Buenos Aires, 
Argentina; and RAUL PARKS, Buenos Aires, Argentina 

Discussants: I. C. RUBIN, New York, N. Y. 
CLAUDE BECLERE, Paris, France 



5. Applications of an Experimental Study for the Interpretation 
of the Tracings of Kymographic Insufflation 

LOUIS BONNET, Former Chief of the Clinic of the Faculty 
of Medicine, Paris, France 

6. Uterotubal Insufflation in Normal and Induced Cycles 

EDUARDO BUNSTER and LILA CORONEL, Gynecology 
Clinic, Salvador Hospital, Santiago, Chile 

7. Pathology of Tubal Occlusion 

EDMUNDO G. MURRAY, Docente Libre in Gynecology, 
University of Buenos Aires; President of the Argentine So- 
ciety for the Study of Sterility, Buenos Aires, Argentina 

8. A New Method of Exploring the Function of the Fallopian 
Tubes 

VICTOR CONILL-SERRA, Associate Professor of Obstetrics 
and Gynecology of the Faculty of Medicine of Barcelona, 
Barcelona, Spain 

9. Contribution to the Diagnosis of Tubal Occlusion 
ALCIDES SENRA and ALTAMIRO VIANA, Rio de Janeiro, 

Brazil 

29 



THURSDAY 

1:30 P.M. 

Section XV-'TROBLEMS IN REPRODUCTION" (Animal) 

(Tudor Room— Room B) 

Honorary Chairman: M. G. FINCHER, Department of Medicine 
and übstetrics, New York State Veterinary College, Cornell 
University, Ithaca, N. Y., U, S. A. 

Chdinmm: JOHN MACLEOD, New York, N. Y. 

V ke-Cliair man : \NTON\0 MIES FILHO, Campo Grande, 

Brazil 

Honorary Secretary: L. V. D. SLUIS, Leeuwarden, Netherlands 

Secretary: C. A. V. BARKER, Giiclph, Ontario, Canada 



u 



THURSDAY 

6. Low Ternperature Storage of Bull Semen in England 

L. E. ROWSON, Cambridge and District Cattle Breeders Ltd., 
The Gravel Pits, Cambridge, England 

7. Studies with Frozen Semen in the United States 

E. L. WILLETT and HENRY DÜNN, American Foundation 
for the Study of Genetics, Madison, Wisconsin 

Discussants for Papers 6 and 7: 

J. A. HENDERSON, Guelph, Ontario. Canada 
JOHN MACLEOD, New York, N. Y. 

Program to be continued tomorrow morning 



1. Canine and Bovine Ovarian Neoplasms 

KENNETH McENTEE, Department of Pathology, New York 
State Veterinary College, Ithaca, N. Y.; and C. P. ZEPP JR., 
Zepp Animal Hospital, New York, N. Y. 

Discussant: PETER OLAFSON, Ithaca. N. Y. 

2. Testicular Biopsies (lllustrated with film) 

C. A. V. BARKER, Ontario Veterinary College, Guelph, On- 
tario, Canada 
Discussant: S. J. ROBERTS, Ithaca, N. Y. 

3. The Quality of Semen of Bulls in Relation to the Number of 
Ejaculations 

VICENTE DE PAULO GRACA and ANTONIO MIES 
FILHO, Institute of Zootechnics, of the Ministry of Agri- 
culture, Campo Grande, Brazil 

Discussant: R. W. BRA I TON, Ithaca, N. Y. 

4. Factors of Male Fertility and Actual Methods for its Objective 
Estimation 

T. BONADONNA, Professor and Director of the "Lazzaro 
Spallanzani" Institute for Artificial Insemination, Milan, 
Italy 

5. Occurrence of Bovine Venereal Trichomoniasis in Bulls Em- 
ployed in Artificial Insemination 

DAVID E. BARTLETT, American Breeders Service, Chicago, 
111., U. S. A. 

Discussant: WAYNE BINNS, Logan, Utah 
30 



Official Banquet, Thursday Evening May 28th, 1953. 
Tickets may be obtained now at the Registration desk. 



Dress Optional 



Hot^l Commodore 
Grand Ball Room 



Sl 



THURSDAY NIGHT 



FRIDAY 



OFFICIAL BANQUET 

GRAND BALL ROOM-HOTEL COMMODORE 

NEW YORK CITY 

Thursday, May 28, 1953, 7 P.M. 

JOHN O. HAMAN, M.D. 
Chairman, Sub-committee for the Banquet 

JOHN MacLEOD, Ph.D. 

Suh-Chairman 



GUESTS 

DR. PEDRO A. GUTIERREZ ALFARO 

Ministro de Sanidad and Asistencia Publica 

Republic of Venezuela 

DR. JOHN F. MAHONEY 

Commissioner of Flealth of the City of New York 

DR. MARCUS D. KOGEL 
Commissioner of Hospitals of the City of New York 






Music by Leo Dryer 
and his orchestra 



Dress Optional 



32 



8:30 A.M. 
Section XVI-"PROBLEMS IN REPRODUCTION" (Animal) 

This Section is a continuation of Section XV 
begun on the previous day. The same Board 
of Officers will continue to conduct this session. 

(Tudor Room— Room B) 

1. Experiences With Sterility in Cattle 

L. V. D. SLUIS, Health Service for Cattle, Leeuwarden, Nether- 
lands 
Discussant: S. J. ROBERTS, Ithaca, N. Y. 

2. Mucus 

H. E. KINGMAN, Wyoming Hereford Ranch, Cheyenne, 

Wyoming, U. S. A. 
General Discussion 

3. The Association of Vibrio Fetus Infection in Cattle with Infer- 
tility 

J. R. LAWSON, Ministry of Agriculture and Fisheries, Veter- 
inary Laboratory, Waybridge, England 

4. The Diagnosis of Bovine Vibriosis 

D. E. HUGHES and H. L. GILMAN, Department of Bac- 
teriology, New York State Veterinary College, Cornell Uni- 
versity, Ithaca, N. Y. 

Discussants for Papers 3 and 4: 

KENNETH McENTEE, Ithaca, N. Y. 

A. H. FRANK, Beltsville, Maryland, U. S. A. 

General Discussion 

Closing and Summation of Program 

8:30 A.M. 

Section XVII-"TREATMENT OF DISORDERED AND 
OCCLUDED FALLOPIAN TUBES** 

(Ballroom— Room A) 

Honorary Chairman: JUAN JOSE CROTTOGINI, Professor of 
Gynecology and Obstetrics, Faculty of Medicine, Montevideo, 
Uruguay 

Chairman: B. BERNARD WEINSTEIN, New Orleans, La., 

U.S.A. 

SS 



FRIDA Y 

Vice-Chairmen: ALVARO DE AQUINO SALLES, Rio de Janei- 
ro, Brazil 
EDUARDO BUNSTER, Santiago, Chile 
RAUL CHEVALIER, Buenos Aires, Argentina 

Honorary Secretary: DARIO SIERRA, Medellin, Colombia 

Secretary: JOSEPH N. SEITCHIK, Philadelphia, Pa., U.S.A. 



1. The Value of Insufflation in the Diagnosis and Therapy of 
Sterility 

MARIOS TRITOFTIDES, Obstetrical and Gynecological 
Surgical Clinic, Limassol, Cyprus 

2. The Value of Uterotubal Insufflation in the Treatment of Tubal 
Obstruction to Uvular Migration 

I. C. RUBIN, Consulting Gynecologist, Mount Sinai Hospital, 
New York, N. Y. 

Discussants: F. MORICARD, Paris, France 
DONATO RAMIREZ, Mexico, D.E. 
ERNEST NAVRATIL, Vienna, Austria 
PENDLETON TOMPKINS, San Francisco, Cal., U. S. A. 

3. Pregnancy in Sterility Gases Following Gombined Gas-Oil-Gas 
(Gynographic Survey) into the Uterotubal Tract Instillations 

ABNER I. WEISMAN, Gynecologist and Obstetrician to the 
Metropolitan Hospital, Associate in Gynecology and Ob- 
stetrics, New York Medical College, Flower and Fifth Avenue 
Hospitals. 

Discussants: NORMANDO ARENAS, Buenos Aires, Argentina 
JOSE GONZALEZ GUERRERO, San Salvador, El Salvador 
ALLAN PALMER, San Francisco, Cal., U.S.A. 

4. "Ethiodan"— as a Contrast Medium for Uterosalpingography 

MARGARET HADLEY JACKSON, Medical Officer to the 
Infertility Clinic of Exeter, Devon, England 

5. The Use of a Radiopaque and Bacteriostatic Mixture for X-Ray 
diagnosis in the Study of Female Sterility 

ANTONIO KARCZMAR, Member of the Staff, American- 
British Cowdray Hospital, Mexico, D.F. 

6. Polyethylene in Tuboplastic Procedures 

JOHN ROCK, Senior Surgeon and Director of Fertility and 
Endocrine Clinic, Free Hospital for Women; Clinical Pro- 
fessor of Gynecology, Harvard Medical School, Boston, Mass., 
U.S.A.; and WILLIAM J. MULLIGAN and CHARLES 
EASTERDAY, Associate Surgeons, Free Hospital for Women, 
Boston, Mass., U.S.A. 

M 



FRIDAY 

Discussants: LOUIS M. HELLMAN, New York, N. Y. 
MARIO A. CASTALLO, Philadelphia, Pa. 
ABNER I. WEISMAN, New York, N. Y. 

7. A New and Efficient Technic of Partial Salpibgectomy in the 

Cure of Sterility 
MANUEL B. RODRIGUEZ LOPEZ, Professor of Clinical Gy- 
necology and Obstetrics, Faculty of Medicine, Montevideo, 
Uruguay 

8. Results of Tubal Surgery in 200 cases of Closure 

RAOUL PALM ER, Chief of Gynecology, Faculty of Medicine, 
Paris, France 

9. Plastic Rings to Retain the Patency of a Newly Formed Tubal 
Ostium 

EDWARD KAHN, Chief of the Sterility Clinic, Department of 
Obstetrics and Gynecology, Sydenham Hospital, New York, 

N. Y. 



1:30 P.M. 

Section XVIII-"UTERINE AND PELVIC PHYSIO-PATHOLOGY" 

(Ballroom— Room A) 

Honorary Chairman: CLAUDE BECLERE, Ancien Chief of 
Gynecology Clinic of the Faculty of Medicine, Paris, France 

Chairman: MANUEL B. RODRIGUEZ LOPEZ, Montevideo, 
Uruguay 

Vice-Chairmen: JOSE MEDINA, San Paulo, Brazil 

PETER BISHOP, London, England 
EDWIN M. ROBERTSON, Kingston, Ontario, 
Canada 

Honorary Secretary: CARLOS COLMEIRO LAFORET, Vigo, 

Spain 

Secretary: CHARLES O. McCORMICK, Indianapolis, Indiana, 
U. S. A. 



1. Physiopathology of Nidation 

OCTAVIO RODRIGUES LIMA, Professor of Obstetrics, Uni- 
versity of Brazil, Rio de Janeiro 

Discussants: I. HALBRECHT, Hadera, Israel 
HECTOR ROCAMORA, Havana, Cuba 
CHARLES STEVENSON, Detroit, Michigan, U. S. A. 



1 



FRIDAY 

2. Observations on the Origin and Specific Function of the Histio- 
cytes in the F'emale Genital Tract 

GEORGE N. PAPANICOLAOU, Department of Anatomy. 
Cornell University Medical College, New York, N. Y. 

Discussant: JOHN W. HUFFMAN, Chicago, 111., U. S. A. 



3. Pelvic Congestion and Fertility 

JUAN JOSE CROTTOGINI, Professor of Obstetrics and 
Gynecology, Faculty of Medicine, Montevideo, Uruguay 

Discussants: EDUARDO BUNSTER, Santiago, Chile 
HOWARD C. TAYLOR, New York, N. Y. 
RAFAEL SALINAS RIVERO, Monterrey, Mexico 

4. Studies of the Contractility of the Pregnant Uterus 

H. ALVAREZ, Associate Professor of Obstetrics and Gyne- 
cology, Faculty of Medicine; Head of the Department of 
Obstetrics and Gynecology, Hospital Pasteur, Montevideo, 
Uruguay: and R. CALDEYRO-BARCIA, Associate Professor 
of Physiology, Faculty of Medicine, Montevideo, Uruguay 

Discussants: CARL T. JAVERT, New York, N. Y. 
J. LAVERGNE, Panama City, Panama 

5. Comparative Study on Phosphatases and Glycogen in the 
Human Uterine Mucus 

FRANCE MARIE MORICARD, In Charge of Endocrine Con- 
sultation of the Gynecology Clinic, Hopital Broca, Paris, 
France 

Discussants: VICTOR CONHILL SERRA, Barcelona, Spain 
W. T. POMMERNKE, Rochester, N. Y. 
AMALIA ERNST, Santiago, Chile 
ROBERTO VAZQUEZ PALLARES, Guadalajara, Mexico 

6. Studies on the Metrial Gland 

BRUNO ALIPIO LOBO, Professor of Histology and Embry- 
ology, Rural University of Brazil, Rio de Janeiro, Brazil 

Discussants: GABRIEL ALVAREZ, Mexico, D.E. 

GILBERT DOUGLAS, Birmingham, Alabama, U. S. A. 

7. Effect of Presacral Nerve Excitation on the Contractility of the 
Human Uterus 

R. CALDEYRO-BARCIA, and H. ALVAREZ, Faculty of 
Medicine, Montevideo, Uruguay 

$6 



FRIDAY 



1:30 P.M. 



Section XIX-"PSYCHOGENIC ASPECTS OF THE 
INFERTILE COUPLE" 

(Tudor Room— Room B) 

Honorary Chairman: ANTONIO CLAVERO NUNEZ, Director 
of the Spanish Revista of Obstetrics and Gynecology; Mater- 
nölogo de la Sanidad Nacional, Barcelona, Spain 

Chairman: ALAN F. GUTTMACHER, New York 

Vice-Chairman: PEDRO FIGUEROA CASAS, Rosario, Argentina 

YVONNE Y.G. SYLVAIN, Port-Au-Prince, Haita 
EDMA ABOUCHDID, Lebanon, Syria 

Honorary Secretary: RAFAELE NAPPI, Naples, Italy 

Secretary: J. JAY ROMMER, Newark, N. J., U.S.A. 



L A Tubal Factor in Functional Sterility of Women 

BORIS B. RUBENSTEIN, Michael Reese Hospital, Chicago, 

IlL, U.S.A. 
Discussants: ANTONIO CLAVERO NUNEZ, Barcelona. 

Spain 

OSBERTO ROSALES M., Guatemala City, Guatemala 

A. HERBERT MARBACH, Philadelphia, Pa., U.S.A. 

2. A Psychodynamic Approach to the Study of Infertility 

E. S. C. FORD, Instructor in Psychiatry; I. FORMAN, Asso- 
ciate Professor of Obstetrics and Gynecology; J. R. WILL- 
SON, Professor and Head of the Department of Obstetrics 
and Gynecology and with the collaboration of other workers 
of the Temple University Hospital, Philadelphia, Pa. 

3. Psychogenic Factors in Sterility 

IRVING C. FISCHER, Mount Sinai Hospital, New York, N. Y. 

4. Fear and Voluntary Sterility Following Cesarean Operation 
SANTIAGO DEXEUS FONT, Director of the Provincial Ma- 

ternity Hospital, Barcelona, Spain 

5. Psychogenic Amenorrhoea 

JOSE NEMIROVSKY, Gynecologist and Obstetrician, San 
Paulo, Brazil 

S7 



FRIDAY 

8:30 P.M. 
Section XX-"HUMAN ARTIFiCIAL INSEMINATION'* 

(Ballroom—Room A) 

Honorary Chairman: ABRAHAM STONE, Director, Margaret 
Sanger Research Bureau, New York, N. Y. 

Chairman: KARL BURGER, Wurzberg, Germany 

Vice-Chairmen: A. CLAVERO NUNEZ, Barcelona, Spain 

K. ANDO, Tokyo, Japan 

MARGARET HADLEY JACKSON, Crediton, 
Devon, England 

Honorary Secretary: WILSON G. McKAY, Oshawa, Ontario, 
Canada 

Secretary: DANIEL B. ROTH, Teaneck, N. J., U.S.A. 



1. Legal Aspects of Artificial Insemination 

SIDNEY B. SCHATKIN, Assistant Corporation Counsel, City 
of New York 

Discussant: NICOLAO DINO DE CASTRO COSTA, Rio de 
Janeiro, Brazil 

2. Therapeutic Donor Insemination 

SOPHIA J. KLEEGMAN, Associate Clinical Professor, Obstet- 
rics and Gynecology, N. Y. University College of Medicine, 
New York, N. Y. 

Discussants: ERNESTO R. DeARAGON, Havana, Cuba 
I. HALBRECHT, Hadera, Israel 
PAUL TOPKINS, New York, N. Y. 
MANUEL MATEOS FOURNIER, Mexico, D.E. 

3. Retention of Fertilization Capacity of Human Spermatozoa 
Stored at Low Temperature with Antibiotics 

ALVARO DE AQUINO SALLES, Director of the Clinical 
Division of the Institute of Gynecology of the University of 
Brazil; and MARIO A. DE CENZO, Chief of the Laboratory 
Staff of the Polyclinic of Botafogo, Rio de Janeiro, Brazil 

Discussants: EDMOND J. FARRIS, Philadelphia, Pa. 
CARL G. HARTMAN, Raritan, N. J. 
ABNER I. WEISMAN, New York 



38 



FRIDAY 

4. The Day of Ovulation as Indicated by 66 Conceptions FoUow- 
ing Artificial Insemination 

DOUGLAS P. MURPHY, University of Pennsylvania; and 
EDMOND J. FARRIS, The Wistra Institute of Anatomy, 
Philadelphia, Pa. 

Discussants: LOUIS L. FREIDMAN, St. Paul, Minn., U.S.A. 
DANIEL B. ROTH, Teaneck, N. J., U. S. A. 

5. The General Situation of Artificial Insemination at the Clinic 
of the Keio University Hospital, Tokyo, Japan 
KAKUICHI ANDO, Director of the Gynecology and Obstetrics 

Department, Keio University School of Medicine, Tokyo, 
Japan 

6. Fertility as Evaluated by Artificial Insemination 
SHELDON PAYNE and ROBERT F. SKEELS, Shelton Clinic, 

Los Angeles, Cal. 



Transactions may be ordered at the Congress at the pre- 
publication price of $21.00. Only a limited edition will be 
published. Be sure to order your copy now. Since meetings 
are being held simultaneously, it will be physically im- 
possible to hear everything that is being presented at the 
Congress. 



39 



SATURDAY 

8:30 A.M. 

Section XXI-"DIAGNOSIS AND TREATMENT OF STERIUTY 

OF UTERINE ORIGIN** 

(Ballroom—Room A) 

Honorary Chairman: ERNESTO R. DE ARAGON, Professor of 
Obstetrics and Gynecology, National University of Havana, 
Havana, Cuba 

Chairman: LINTON MORRIS SNAITH, Newcastle, England 
Vice-Chairmen: ALFONSO ALVAREZ-BRAVO, Mexico, D.F. 

R. MORICARD, Paris, France 

LESLIE W. GLEADELL, Melbourne, Australia 

Honorary Secretary: ALEJANDRO POU-DE-SANTIAGO, Mon- 
tevideo, Uruguay 

Secretary: FRANCIS M. INGERSOLL, Boston, Mass., U. S. A. 



1. Hypoplasia of the Uterus: Diagnosis and Treatment 

JUAN CARLOS AHUMADA, Titular Professor of Gynecol^ 
ogy, University of Buenos Aires; Chief of the Gynecology 
Service Hospital of Clinicas, Buenos Aires, Argentina: and 
RAUL M. CHEVALIER, Chief of the Sterility Center, 
Buenos Aires, Argentina 

Discussant: JOSE MEDINA, San Paulo, Brazil 

2. A Preliminary Series of Gases of Uterine Hypoplasia Treated 
by Local Injection of an Estrogen Emulsion 

CEDRIC LANE-ROBERTS, Gynecologist to Philip Hill Par- 
enthood Centre, Royal Northern Hospital, London, England 

Discussant: KARL J. KARNAKY, Houston, Texas 

S. A Method of Studying the Uterine Canal by Hysteroscopic 
Examination 

W. B. NORMENT, Surgeon, Wesley Long Hospital, Greens- 
boro, N. C., U. S. A. 

Discussant: MAXWELL B. ROLAND, New York, N. Y. 

4. Hysterography in the Diagnosis of Sterility 

CLAUDE BECLERE, Ancien Chief of the Gynecology Clinic, 
Faculty of Medicine, Paris, France 

Discussants: JOSE NEMIROVSKY, San Paulo, Brazil 
ABNER I. WEISMAN, New York, N. Y. 

40 



SATURDAY 

5. Fibromyomata Uteri and Sterility 

ALFONSO ALVAREZ-BRAVO, Professor of Clinical Abdom- 
inal Surgery, University of Mexico School of Medicine; Chair- 
man of the Gynecological Department of the Spanish Hos- 
pital of Mexico, Mexico, D.F. 

Discussants: JUAN JOSE CROTTOGINI, Montevideo, Uru- 
guay 

LICINIO DUTRA, San Paulo, Brazil 
EDWARD SOLOMONS, Dublin, Ireland 

6. Results of the Strassman Metroplasty in Habitual Abortion 
due to Congenital Malformation 

JOSEPH A. SCHOCKAERT, Professor of Gynecology and Ob- 
stetrics, University of Louvain, Louvain, Belgium 
Discussant: ERWIN O. STRASSMAN, Houston, Texas 

7. Endometrial Aspiration Smears in the Study of Infertility 
GEORGE H. ROMBERG, Director of Fertility Clinic, Gyne- 

cologic Outpatient Department, Hospital for Joint Diseases, 
New York, N. Y. 

8. The Role of Genital Displacement in Female Sterility 
FRANCISCO LUQUE, Madrid, Spain 



8:30 A.M. 

Section XXII-"PROBLEMS OF CHILD ADOPTION** 

(Tudor Room— Room B) 

Honorary Chairman: KAKUICHI ANDO, Director of the De- 
partment of Gynecology and Obstetrics, Keio University School 
of Medicine, Tokyo, Japan 

Chairman: J. GARCIA ORCOYEN, Madrid, Spain 

Vice-Chairmen: A. MOURAO FILHO, Rio de Janeiro, Brazil 

DAPHNE CHUN, Hong Kong, China 

ARTHUR APARICIO JARAMILLO, Bogota, 
Colombia 

Honorary Secretary: ARTURO ACH ARD, Montevideo, Uruguay 
Secretary: DANIEL B. ROTH, Teaneck, N. J., U.S.A. 



1. Introductory Remarks 

ABNER I. WEISMAN, Chairman, Committee on Arrange- 
ments, World Congress 

41 



SATURDAY 

2. Indications for Child Adoption 

HANS LEHFELDT, Lenox Hill Hospital and Beth David Hos- 
pital, New York, N. Y. 

3. The Role of the Recognized Adoption Agency in Child Adop- 
tion 

FLORENCE G. BROWN, Executive Director, Free Synagogue 
Child Adoption Committee, New York, N. Y. 

4. The Role of the Physician in Child Adoptions 

FRED B. KYGER, Chief Obstetrician, Fairmount Maternity 
Hospital, Kansas City, Mo., U.S.A. 

5. Child Adoption froni the Viewpoint of a Psychiatrist 
WILLIAM E. SORREL, Associate Attending Neuropsychiatrist 
and Chief of Clinical Psychiatry, Jewish Memorial Hospital, 

New York, N. Y. 

6. Child Adoption in China 

DAPHNE CHUN, Queen Mary Hospital, Hong Kong 

7. Fertility After Child Adoption 

WILLIAM S. KROGER, Assistant Clinical Professor of Ob- 
stetrics and Gynecology, Chicago Medical School, Chicago, 
111., U.S.A. 

8. Adoption or Donor Artificial Insemination? 

MARGARET HADLEY JACKSON, Medical Officer to Infer- 
tility Clinic at the Royal Devon and Excter Hospital, Crediton, 
Devon, England 



1:30 P.M. 

Section XXIII-"THREATENED AND HABITUAL ABORTION** 

(Ballroom— Room A) 

Honorary Chairmen: OCTAVIO RODGRIGUES LIMA, Pro- 
fessor of Obstetrics, University of Brazil, Rio de Janeiro, Brazil 

Chairman: I. HALBRECHT, Hadera, Israel 

Vice-Chairmen: EDWARD SOLOMONS, Dublin, Ireland 

FRANCE MARIE MORICARD, Paris, France 
TOMAS ARMSTRON, Havana, Cuba 

Honorary Secretary: JOSE GONZALEZ GUERRERO, San Sal- 
vador, El Salvador 

Secretary: M. M. BRAUNSTEIN, Montreal, Canada 
42 



SAIUROAY 

1. The Effect of Artificial Abortion on Fertility 

JOSEPH G. ASHERMAN, Director, Women's Hospital Tel- 
Aviv, Israel 

Discussants: ARTHUR FIRST, Philadelphia, Pa. 
KATHLEEN M. D. HARDING, London, England 

2. Treatment of Habitual Abortion 

JORGE DE REZENDE, Professor of Obstetrics, School of Medi- 
cine and Surgery, Rio de Janeiro, Brazil 

Discussants: HERBERT S. KUPPERMAN, New York, N. Y. 
LINTON MORRIS SNAITH, Newcastle, England 
GUILLERMO VAUTRIN, Havana, Cuba 

3. Pregnancy Complicating Diabetes 

PRISCILLA WHITE, Physician, New England Deaconess Hos- 
pital, Boston, Mass., U.S.A. 

Discussants: EDWARD C. HUGHES, Syracuse, New York 
ARMINDO DE OLIVEIRA SARMENTO, Rio de Janeiro, 

Brazil 
FLA VIA MIGUEZ DE MELLO, Rio de Janeiro, Brazil 

4. The Cervix in Habitual Abortion 

J. GARCIA ORCOYEN, Professor of Gynecology, University 

of Madrid, Madrid, Spain 
Discussants: FERNANDO DE ALMEIDA, Lisbon, Portugal 

A. F. LASH, Chicago, 111., U.S.A. 

JULIO ORTIZ PEREZ, Havana, Cuba 

JOSE G. MARTINEZ, Monterrey, Mexico 

5. Treatment o£ Premature Labor 

MANUEL B. RODRIGUEZ LOPEZ, Professor of Obstetrics 
and Gynecology, Faculty of Medicine, Montevideo, Uruguay 

Discussants: A. GUIMARAES FILHO, Rio de Janeiro, Brazil 
MARTIN GARRIGA ROCA, Madrid, Spain 

6. Role of Congenital Uterine Malformations and of Acquired 
Deformities of the Uterine Cavity in the Pathogenesis of Female 
Infertility (Habitual Abortion) 

I. HALBRECHT, Director of Hadera Hospital, Hadera, Israel 
Discussants: I. C. RUBIN, New York, N. Y. 

MARGARET MOORE WHITE, London, England 

7. Vulvar Fluorescence in the Diagnosis and Treatment of Threat- 
ened Abortion 

M. SYDNEY MARGOLESE, Clinical Instructor, Department 
of Medicine, University of California, Los Angeles, Cal., 
U.S.A. 

Discussant: PAUL H. FRIED, Philadelphia, Pa., U.S.A. 

4S 



SATURDAY 

8 Premature Labor 

SUBODH MITRA, Professorin-Charge of Department of Ob- 
stetrics and Gynecology, R. G. Kar Medical College, Calcutta, 
India 

9. Role of Extra-Human Factors in Human Fertility 

JOSE RAMIREZ-OLIVELLA, Professor of Obstetrics, Uni- 
versity of Havana, Havana, Cuba 

10. Comparative Study of the Value of Diethylstilbestrol and 
Progesterone in the Treatment of Threatened Abortion 
LUIZ CASTELAZO AYALA, Mexico, D.F. 



1:30 P.M. 
Section XXIV-"REPORTS FROM INFERTIUTY CLINICS" 

(Tudor Room— Room B) 

Honorary Chairman: PEDRO A. GUTIERREZ ALFARO, Minis- 
tro de Sanidad y Asistencia Publica, Caracas, Venezuela 

Chairman: KATHLEEN M. D. HARDING, London, England 

Vice-Chairmen: EDMUNDO G. MURRAY, Buenos Aires, Argen- 
tina 
JUAN WOOD, Santiago, Chile 
L. I. SWAAB, Amsterdam, Netherlands 

Honorary Secretary: ORLANDO BAIOCCHI, Rio de Janeiro, 
Brazil 

Secretary: ANNA K. DANIELS, New York, N. Y. 



1. The Outcome of Pregnancy in Women Attending an Infertility 
Clinic 
GERALD I. M. SWYER, Consultant Endocrinologist to the 

Obstetric Department, University College Hospital, London, 

England 

Discussants: ALVARO DE AQUINO SALLES, Rio de Janeiro, 
Brazil 

CARL JOHNSON, New Haven, Conn., U. S. A. 
B. BERNARD WEINSTEIN, New Orleans, La., U. S. A. 

44 



SATURDAY 

2. Evaluation of Therapy in 500 Childless Wives 

V. H. TURNER and C. D. DAVIS, Department of Obstetrics 
and Gynecology, School of Medicine, Duke University, Dur- 
ham, N. C, U. S. A. 

Discussant: CLAIR E. FOLSOME, New York, N. Y. 

3. Infertility: Clinical Impressions Obtained from a Review of 
1000 Cases 

ROBERT B. WILSON, Section of Obstetrics and Gynecology, 
Mayo Clinic, Rochester, Minnesota, U. S. A. 

Discussant: G. E. SEEGAR-JONES, Baltimore, Md., U. S. A. 

4. Medical Treatment in Pregnancy Following Sterility 

CLAUDE BECLERE, Ancien Chief, Gynecology Clinic of the 
Faculty of Medicine, Paris, France 

5. The Problem of Sterility in Turkey: Statistics and Studies Based 
on the Etiology, Diagnosis and Treatment 

SERIF CANGA, Professor of Obstetrics and Gynecology, Medi- 
cal School of Ankara University, Ankara, Turkey 

6. Certain Aspects of Fertility and Sterility in Muselman Women 
of North Africa 

HENRI FULCONIS, Clinic of Obstetrics and Gynecology, 
Algiers, Algeria 

7. An Analysis of Accidental Pregnancies Occurring During In- 
fertility Studies 

DAVID R. WEIR AND ASSOCIATES, Maternal Health Asso 
ciation of Cleveland, Ohio 

8. Sterility and Fertility Problems in Syria 
ZARE ARSLANIAN, Aleppo, Syria 



45 



SUN DAY 



2 P.M. 

Section XXV-*'THE CLOSING SESSION" 

(Ballroom— Room A) 

Resolutions 

Awards 

Awarding of Diplomas to Members of the 
International Fertility Association 

Introduction of New Members of the American Society 

for the Study of Sterility 

The Roll Call of Nations 

Final Summation of the Congress 



f 



46 



SCIENTIFIC MOTION PICTURES 

Monday, May 25th through Friday, May 29th 

Daniel B. Roth, M.D., Chairman 
Teaneck, N. J. 

John Cannis, M.D. 

Giro Tarta, M.D. 

Raul Ortiz de la Pena, M.D. 

A. R. Abarbanel 

Assistant Professor of Obstetrics and Gynecology, College of 
Medical Evangelists, Los Angeles, California, U. S. A. 

MYOMECTOMY AND MYOMETRIAL 
RECONSTRUCTION 

Louis B. Bachrach 

Associate in Urology, Prince Georges General Hospital, 

Cheverly, Md., U. S. A. 
Visiting Urologist, George Washington University Hospital, 

Washington, D. C, U. S. A. 

VASO EPIDIDYMOSTOMY FOR OBSTRUCTIVE 

IN FERTILITY 
CONGENITAL BILATERAL ATRESL\ 

C. A. V. Barker 

Associate Professor, Department of Medicine and Surgery, 
Division of Animal Reproduction, Ontario Veterinary College, 

Guelph, Ontario, Canada 

TESTiCULAR BIOPSY TECHNICS IN BULLS 

Adib Antonio Couri 
Institute of Biology, Rio de Janeiro, Brazil 

OFFICE TECHNIC OF TESTICULAR BIOPSY 

Joseph B. Doyle 

Assistant Clinical Professor of Obstetrics, Tufts Medical School, 

Boston, Mass., U. S. A. 

OBSERVATION OF THE HUMAN TUBO OVARIAN 

MECHANISM WITH THE PELVISCOPE 

AUTONOMIC UTEROTUBAL DENERVATION 

Carlos D. Guerrero 

Clinical Professor Obstetrics and Gynecology, National University 

Schools of Medicine, Mexico, D.F. 

ESTERILIDAD POR MIOMA CAVITARIO Y 
MIOMECTOMIA A TRAVES DE HISTEROTOMIA 

(Cavitary Uterine Myoma and Myomectomy 
through Hysterotomy) 

47 



I i. 



Jane E. Hodgson 

Ancker Hospital, St. Paul, Minnesota, U. S. A. 

THE RANA PIPIENS FROG TEST FOR PREGNANCY 

Francis M. Ingersoll 

Assistant Surgeon, Massachusetts General Hospital, 

Boston, Mass., U. S. A. 

STEIN-LEVENTHAL SYNDROME 

Antonio Karczmar 
Medical Staff, The American-British Cowdray Hospital, 

Mexico, D.F. 

THE USE OF A RADIOPAQUE AND BACTERIOSTATIC 

MIXTURE L-E (LIPIODOL F.-ETHER) FOR 

HYSTEROGRAPHY AND HYSTEROSALPINGOGRAPHY 

A. Lopez de Nava 
Chief of the Gynecological and Obstetrical Department of the 

Navy Hospital, Mexico, D.F. 
Professor of Obstetrics, National University of Mexico School of 

Medicine, Mexico, D.F. 
A GASE OF DOUBLE UTERUS AND DOUBLE VAGINA- 

STRASSMANN'S OPERATION 

Maurice Mayer 

Department of Gynecology, Hospital of St. Antoine, Paris, France 

TUBOPLASTY: TECHNIC OF UTEROTUBAL 

IMPLANTATION 

Rene Moricard 

Directeur du Laboratoire d'Hormonologie de l'Ecole des Hautes 

Etudes de l'Universite de Paris, Paris, France 

FONCTION MEIOGENE DU LIQUIDE FOLLICULAIRE 

ET RECHERCHES SUR LA FECONDATION 

(A quantitative study by hormone micro-injection into the ovarian 

follicle of a meiogenic function of the follicular liquid: 

Problems of human application) 

Edgar da Rosa Ribeiro, Rio de Janeiro, Brazil 

NUEVO MODELO DE APARATO PARA 
HISTEROSALPINGOGRAFIA 

(A New Apparatus for Hysterosalpingography) 

TECNICA DE ANASTOMOSIS TUBARIA 

(Technic of Tubal Anastamosis) 

George H. Romberg 

Medical Staff, White Plains Hospital, White Plains, N. Y., U. S. A. 

ENDOMETRIAL ASPIRATION TECHNIC 

48 



Schering Corporation, Bloomfield, N. J., U. S. A. 

PHYSIOLOGY OF NORMAL MENSTRUATION 

(English and Spanish) 

MALE SEX HORMONE 

(English and Spanish) 

Dr. Shirodkar 

Professor of Obstetrics and Gynecology, Grant Medical College 

Bombay, India 

DIRECT VISION TUBAL PATENCY TEST AND 
TECHNIQUE OF UTEROTUBAL IMPLANTATION 

Abraham Stone 

Director, Fertility Service, Margaret Sanger Research Bureau, 

New York, N. Y., U. S. A. 

BIOLOGY OF CONCEPTION 



Transactions may be ordered at the Congress at the pre- 
publication price of $21.00. Only a limited edition will be 
published. Be sure to order your copy nofw. Since meetings 
are being held simultaneously, it will be physically im- 
possible to hear everything that is being presented at the 
Congress. 



49 



SCIENTIFIC EXHIBITS 

Chairman: Charles m. mclane 
Sub-Chairmen: Edward c. hughes and rita s. finkler 

Ballroom Foyer 



A NEW IMPROVED X-RAY OPAQUE MASS FOR 
HYSTEROSALPINGOGRAPHY 

I. C. RUBIN, M.D. 

ERNEST MYLLER, M.D. 

CARL G. HARTMAN, PH.D. 

New York City, N. Y. and Raritan, N. J. 
SOME INTERESTING UTEROTUBAL RADIOGRAPHS 

CERIF CANGA, M.D. 

University of Ankara, Ankara, Turkey 
INVESTIGATION OF TUBAL PHYSIOLOGY 

AMERICO STABILE, M.D. 

Facultad de Medicina, Montevideo, Uruguay 

4 

A NEW NON-BIOLOGICAL PREGNANCY TEST 

HOWARD W. JONES, JR., M.D. 
G. E. S. JONES, M.D. 

Baltimore, Maryland 

5 

A FIFTEEN YEAR STUDY OF STERILITY 

JUAN WOOD, M.D. 
AMALIA ERNST^ M.D, 

University of Chile, Santiago, Chile 

6 

PRE-COLOMBIAN CENTRAL AND SOUTH AMERICAN 

FERTILITY SYMBOLS: PRIMITIVE AFRICAN AND 

OCEANIQUE SEXUAL SYMBOLS 

ABNER I. WEISMAN, M.D. 
JULIUS CARLEBACH 

New York City, N. Y. 

7 

THE CYTOLOGIC APPROACH TO 

GYNECOLOGIC DISORDERS 

EMANUEL L. HECHT, M.D. 
WILLIAM E. STUDDIFORD, M.D. 

New York University — Bellevue Medical Center 

University Hospital 
New York City, N. Y. 

50 



9 



10 



11 



12 



8 

A SIMPLE TEST FOR THE DETERMINATION OF 

PREGNANCY AND OVULATION USING 

CERVICAL MUCUS SECRETION 

MAXWELL ROLAND, M.D. 

Queens General Hospital, New York City, N. Y. 

CERVICAL MUCUS "SPINNBARKEIT" TEST 

FOR OVULATION 

U. J. SALMON, M.D. 

New York City, N. Y. 

USE OF RADIOPAQUE AND BACTERIOSTATIC 

MEDIUM (LIPIODOL-E7 HER MEDIUM) IN 

GYNECOLOGICAL X-RAY DIAGNOSIS 

ANTONIO KARCZMAR, M.D. 

American-British Cowdray Hospital, Mexico, D.E. 
USE OF THE PELVISCOPE IN CULDOTOMY 

JOSEPH B. DOYLE, M.D. 

Department of Obstetrics, Tufts Medical School 

Boston, Mass. 

A STUDY OF THE POST-OVULATORY PHASE OF 

THE MENSTRUAL CYCLE IN RELATION TO AGE: 

THE LENGTH OF THE PREMENSTRUAL PHASE 

R. F. VOLLMAN, M.D. 

Geneva, Switzerland, and New York, N. Y. 

IS 

PELVIC PHOTOSCOPY DURING THE OVARIAN CYCLE 

MELVIN R. COHEN, M.D. 
HENRY S. GUTERMAN, M.D. 

Michael Reese Hospital, Chicago, 111. 

14 

"POLYETHYLENE INTUBATED SALPINGOPLASTY" 
A NEWER APPROACH TO CLOSED TUBE STERILITY 

MARIO A. CASTALLO, M.D. 
AMOS S. WAINER, M.D. 

Jefferson Medical College, Philadelphia, Pa. 

15 

ELECTRONMICROSCOPIC AND PHASE MISCROSCOPIC 
STUDY OF HUMAN SPERMATOZOA 

MEYER D. SCHNALL, M.D. 

Mount Sinai Hospital, New York, N. Y. 

51 



16 

CULDOSCOPIC DIAGNOSIS OF GYNECOLOGIC DISEASE 

ALBERT DECKER, M.D. 

New York Medical College 

MARTIN J. CLYMAN, M.D. 

New York City, N. Y. 



17 



18 



19 



A METHOD OF STUDYING THE UTERINE CANAL 
BY HYSTEROSCOPIC EXAMINATION 

W. B. NORMENT, M.D. 

Wesley Long Hospital, Greensboro, N. C. 
TESTICULAR BIOPSY 

FRED A. SIMMONS, M.D. 

Harvard Medical School, Boston, Mass. 
TUBAL INSUFFLATION 

LOUIS BONNET, M.D. 

Paris, France 

NORMAL AND ABNORMAL DEVELOPMENT 

OF THE HUMAN EMBRYO 

Medical Museum, Armed Forces Institute of Pathology 

Washington, D. C. 

PATHOLOGY OF TUBAL OCCLUSION 

EDMUNDO G. MURRAY, M.D. 

Telömaco Susini Institute of Pathology School of Medicine, 

University of Buenos Aires 
Buenos Aires, Argentina 



20 



21 



22 



23 



THE CAUSE OF MANOMETRIC OSCILLATIONS 
DURING UTEROTUBAL INSUFFLATION 

EDUARDO BUNSTER, M.D. 

Hospital del Salvador, Santiago-de-Chile, Chile, S. A. 

LA MATURATION OVULAIRE, LA FECONDATION 

ET L'EXPLORATION CYTO-HORMONALE 

(MUQUEUSE UTERINE HUMAINE) 

R. MORICARD, M.D. 
F. MORICARD, M.D. 

Hospital Broca, Paris, France 



52 



24 



THE CRYSTALLIZATION TEST OF THE 
CERVICAL MUCUS 

ARTHUR CAMPOS DA PAZ, M.D. 
LUIS DA COSTA LIMA, M.D. 
ORLANDO BAIOCCHI, M.D. 

Rio de Janeiro, Brazil 



25 
26 
27 



28 



29 



30 



31 



FETAL SALVAGE PROGRAM: 
PRECONCEPTIONAL THERAPY 

E. C. HUGHES, M.D. 

F. J. SCHOENECK, M.D. 

C. W. LLOYD, M.D. 

A. W. VAN NESS, M.D. 

Department of Photography 

Department of Obstetrics, State University of New York 

State University of New York Medical Center at Syracuse 

College of Medicine, Syracuse, N. Y. 



ABNORMAL OVULATION 

WALTER W. WILLIAMS, M.D. 

Springfield, Mass. 



A NEW APPARATUS FOR INTRAUTERINE 
INSTILLATION OF SEMEN IN ARTIFICIAL 

INSEMINATION 

DELFINO GALLO, M.D. 

Guadalajara, Jal., Mexico 



FEMALE STERILITY: ENDOCRINE FACTORS 

RITA S. FINKLER, M.D. 
SYLVIA F. BECKER, M.D. 

Beth Israel Hospital, Newark, N. J. 



STUDIES ON THE CONTRACTILITY OF THE 
HUMAN PREGNANT UTERUS 

H. ALVAREZ, M.D. 
R. CALDEYRO-BARCIA, M.D. 

Facultad de Medicina, Montevideo, Uruguay 



53 



WOMEN'S ENTERTAINMENT 

(Headquarters— Georgian Lounge— Henry Hudson Hotel) 
Registration Fee $10.00 It pays to register and go to everything 

Registration fee includes cost of all events and bus transporta- 
tion (banquet not included). Non-registrants will be expected to 
pay the listed fee for each event. Tickets must be obtained for 
all admissions. 

Free tickets for many Radio and Television shows will be avail- 
able all week. Simply ask us for them. 

The Women's Headquarters Lx)unge will be open all week for 
your pleasure and comfort and the Hostess on duty will be happy 
to serve you. All information and tickets for the various functions 
will be available at the WOMEN'S REGISTRATION D£SK 
(2nd floor-Henry Hudson Hotel) or in the WOMEN'S HEAD- 
QUARTERS LOUNGE (Georgian Room) at the same hotel. 

EVENTS 
SUNDAY May 24 

Advance registration all day Sunday. It is expected that all 

the women will register. 

MONDAY May 25th 

Registration all day Monday. 8:30 P.M.— Ladies are invited 
to attend the Inaugural Session of the Congress in the Ball- 
room of the Henry Hudson Hotel. Please wear your badge 
to gain admittance to meeting. 

FASHION SHOW - LUNCHEON 

TUESDAY May 26th 

12:30 P.M. Fashion show sponsored by Saks Fifth Avenue and 
luncheon in the Ballroom of the Hotel Pierre at 6 Ist Street 
and Fifth Avenue. Commentary by Miss Nola Luxford, 
Fashion Coordinator, Hotel Pierre. Spanish and French trans- 
lators will be present through the courtesy of Saks Fifth 
Avenue. 

—Fee to non-registrants $5.00 

BOAT TRIP 

WEDNESDAY May 27th 

1:15 P.M. Buses will leave the Henry Hudson Hotel promptly 
for the Circle Line pier located at 43rd Street and the Hudson 
River. The boat trip around Manhattan is a must for visitors 
to New York. The trip takes three hours. Buses will meet the 
boat and return to the hotel at the end of the trip. This 
event is OPEN TO MEN. 

—Fee to non-registrants $3.00 including bus transportation 

54 



^:: 



LEVER HOUSE TOUR - BEAUTY DEMONSTRATION 

THURSDAY May 28th 

9:30 A.M, Buses will leave the Henry Hudson Hotel for a tour 
of Lever House. Fhis edifice is one of the most modern build- 
ings in the City of New York. A demonstration on "make-up" 
and Souvenirs for all who attend. Lever House is located on 
Park Avenue at 53rd Street. 

—Fee to non-registrants $1.00 includes transportation 

A limited number of hairdresser appointments can be made 
at Antoines of Sakes Fifth Avenue for Thursday afternoon. 
All requests must be made by Monday at 5 P.M. 
7:30 P.M. Official Banquet of the Congress at the Commodore 
Hotel. (Reservations should be made at the Main Registra- 
tion Desk.) 



BUS TOUR 
FRIDAY May 29th 

2:30 P.M. Buses will leave the Henry Hudson Hotel promptly 
for a Grand Tour of New York. Many of the wonders of New 
York will be pointed out on this trip, with special emphasis 
on the UN buildings. The visit and view from the top of 
the Empire State Building will be of special interest to all. 
The trip lasts three hours. Tour notes will be printed in 
Spanish and English and will be distributed to all. 

—Fee to non-registrants $4.00 

SATURDAY May 30th 

8:30 A.M. The ladies are invited to attend the Scientific Ses- 
sion of the Congress on Child Adoption on Saturday morning. 
Please wear your badge to gain admittance to meeting in the 
Tudor Room (Room B) second floor of the Henry Hudson 
Hotel. 

SUNDAY May 31 st 

2:00 P.M. The ladies are cordially invited to attend the 
Closing Session of the Congress. 



55 



Booth 24 - 
Booth 25 
Booth 26 
Booth 27 
Booth 28 
Booth 29 
Booth 30 
Booth 3 1 
Booth 32 
Booth 33 
Booth 34 
Booth 35 
Booth 36 
Booth 37 
Booth 38 
Booth 39 
Booth 40 
Booth 41 



TECHNICAL EXHIBITORS 

(Second Floor Corridors) 

The Purdue Frederick Company 

Campbell Associates 

The Grafax Company 

Westwood Pharmaceutical Corporation 

Encyclopedia Americana 

Clay Adams Company 

Milex Products 

Kidde Manufacturing Corp. 

Cameron Surgical Specialty Company 

Goodman-Kleiner Company 

- International Fertility Association 

- American Society for the Study of Sterility 

- World Congress on Fertility and Sterility 

- American Cystoscope Makers, Inc. 

- "Teaching Clinics in New York" 

- Ortho Pharmaceutical Corporation 

- "Distinguished Books" 

- E. Fougera and Company 



SOCIETIES AND INSTITUTIONS OFFICIALLY 
REPRESENTED AT THE CONGRESS 

STERILITY SOCIETIES 

American Society for the Study of Sterility 

Argentine Society for the Study of Sterility 
(Dr. Edmundo G. Murray and others) 

Brazilian Society for the Study of Sterility 
(Dr. A. Campos da Paz) 

British Society for the Study of Fertility 

Canadian Committee for the Study of Sterility 

Cuban Society for the Study of Sterility 

French Society for the Study of Sterility 

Mexican Association for the Study of Sterility 

Monterrey Society for the Study of Sterility 

New York Fertility Society 

Spanish Society for the Study of Sterility 
(Dr. A. Clavero Nunez) 

Uruguayan Society for the Study of Sterility 

(Drs. Manuel Rodriguez Lopez and Arturo Achard) 

Venezuelan Society for the Study of Sterility 



MEDICAL SOCIETIES 



6© 



American Medical Association 

(dR. PAUL M. WERNERJ 

Editorial Board of Obstetricia 

y Ginecologia 

Latino- Americana 
(dr. jacobo rosenvasser) 

Gynecological Society of Israel 

(dr. JOSEPH G. ASHERMAN) 

Italian Endocrine Society 
(dr. d. andreani) 

Kupat Holim of Israel 
(dr. I. halbrecht) 

N.S.V.H.— Netherland Society 

of Sexual Reform 
(dr. l. l swaab) 



Science Council of Japan 
(dr. kakuichi ando) 

Sociedad Chilena de 

Obstetricia and Ginecologia 

(drs. EDUARDO BUNSTER, JUAN 
WOOD AND AMALIA ERNST) 

Sociedad de Obstetricia y 
Ginecologia de Rosario 
(Argentina) 

(drs. PABLO BORRAS AND 
PEDRO FIGUEROA CASAS) 

Soci^t^ Francaise de 
Gynecologie 

(drs. RAOUL PALMER AND 
MICHEL TURPAULT'i 



67 



UNIVERSITIES 



American University at 

Beirut, Lebanon 
(dr. edma abouchdid) 

Faculty of Mediane, 
Montevideo, Uruguay 

(dRS. MANUEL B. RODRIGUEZ LOPEZ 
AND ARTURO ACHARD) 

Rutgers University, 
College of Pharmacy 

(DAVID FROST) 

University of Barcelona 

(dr. VICTOR CONHILL-SERRA) 

University of Chile 

(drs. eduardo bunster, amalia 

ERNST and JUAN WOOD) 



University of Buenos Aires 

(dr. JUAN CARLOS AHUMADA) 

University of Guadalajara 
(dr. delfino gallo) 

University of Hong Kong 
(dr. daphne chun) 

University of Paraguay 
(drs. julio morales and 
eusebio villamayer) 

University of Salonica, 
at Athens 

(dr. KONSTANTINE VLACHOS) 



GOVERNMENT AGENCIES 



Republic of Argentina 
(Ministro de Salud) 
(dr. adolfo jassin) 

Republic of Brazil 
Department of Agriculture 

(dr. ANTONIO MIES FILHO) 

Republic of Brazil 
(dr. a. campos da paz) 

Republic of Costa Rica 
(dr. m. teran valls) 

Republic of El Salvador 

(drs. JOSE GONZALEZ GUERRERO, 
NARCISO DIAZ BAZAN 
SALVADOR BATISTA MENA) 

Greek Ministry of Agriculture 

(dr. KONSTANTINE VLACHOS) 



Italian Government 

(dr. GIUSEPPE TESAURO) 

Mexican Navy 

(dr. LOPEZ DE NAVA) 

Republic of Portugal 
(Ministerio do Ultramar) 

(dr. PEDRO MONJARDINO) 

Sweden (Royal Ministry for 
Foreign Affairs) 

(drs. AXEL WESTMAN AND 
ERIC NORDLÄNDER) 

Uruguay (Government and 

Faculty of Medicine) 
(dr. americo stabile) 

Venezuela 

(dr. CARLOS NOUEL) 



] 



58 



PROGRAM COMMITTEE 
Chairman: a. campos da paz 

S. LEON ISRAEL 

Sub-Chairmen: m. g. fincher 



BANQUET COMMITTEE 

Chairman: john o. haman 
Sub-Chairman: john macleod 

WELCOME COMMITTEE 
Chairman: j. p. greenhill 



M. LEOPOLD BRODNY 
ADOLFO JASSIN 
E. CABEAUX 



MARTIN L. STONE 
RAUL ORTIZ DE LA PENA 
RAFFAELE NAPPI 



RECEPTION COMMITTEE 

Chairman: samuel l. sikgler 

Sub-Chairman: Charles h. birnberg 

Sub-Chairman: abelardo salas g. 



ROBERT S. HOTCHKISS 
CHARLES M. MC LANE 
UDALL J. SALMON 
I. C. RUBIN 
CHARLES L. BUXTON 
ALBERT DECKER 
LOUIS M. HELLMAN 
SOPHIA J. KLEEGMAN 
RAPHAEL KURZROK 
JOHN MACLEOD 
ABRAHAM STONE 
M. LEOPOLD BRODNY 
LEONARD F. CINER 
ANNA K. DANIELS 
ERALE T. ENGEL 
CLAIR E. FOLSOME 
RANDOLPH GEPFERT 
JOSEPH GOLDZIEHER 



ARTHUR V. GREELEY 
EDWARD KAHN 
HERBERT S. KUPPERMAN 
J. IRVING KUSHNER 
MAXWELL ROLAND 
S. S. ROSEN FELD 
DANIEL B. ROTH 
MEYER D. SCHNALL 
PAUL TOPKINS 
LEO WILSON 
LAWRENCE Q. CRAWLEY 
IRVING C. FISCHER 
SHERWIN A. KAUFMAN 
IRVING I. KURLAND 
LOUIS PORTNOY 
GEORGE H. ROMBERG 
MARTIN L. STONE 



59 



COMMITTEE FOR LATIN-AMERICAN NIGHT 

Chairman: abelardo salas g. 

Argentina— ADOLFO jassin Guatemala— osberto rosales m. 

Brazil-ALVARO de aquino salles Mexico— carlos d. guerrero 



Chile— JUAN WOOD 
Columbia— RODULFO camero 

Cuba— HECTOR ROCAMORA 

El Salvador— JOSE Gonzales 

GUERRERO 

Costa Rica— M. teran valls 



Peru— JORGE ASCENZO c. 

Panama— A. carrizo 
Paraguay— juLio morales 
Haiti— YVONNE sylvain 
Uruguay— A. pou-de-santiago 
Venezuela— CARLOS nouel 



NOTES 



COMMITTEE ON SCIENTIFIC EXHIBITS 

Chairmen: Charles m. mclane 

Sub-Chairmen: edward c. hughes 

RITA FINKLER 

COMMITTEE ON MOTION PICTURES 
Chairman: daniel b. roth 

JOHN CANNIS CIRO TARTA 

RAUL ORTIZ DE LA PENA 

WOMEN'S CONVENTION COMMITTEE 
MRS. MARTIN L. STONE, Chairman 

NEW YORK CITY 

MRS. G. PAPANICOLAOU 
MRS. M. ROLAND 
MRS. G. ROMBERG 
MRS. I. C. RUBIN 
MRS. M. SAGARRA 
MRS. M. SCHNALL 
MRS. S. L. SIEGLER 
MRS. H. THOMAS 
MRS. A. WEISMAN 
MRS. W. W. WILLIAMS 

WOMEN'S HEADQUARTERS LOUNGE— GEORGIAN LOUNGE 
HENRY HUDSON HOTEL 



MRS. 


M 


. COHEN 


MRS. 


C. 


CHARNY 


MRS. 


A. 


DONNENFELD 


MRS. 


I. 


FISCHER 


MRS. 


C. 


FOLSOME 


MRS. 


A. 


GUTTMACHER 


MRS. 


R. 


HOTCHKISS 


MRS. 


S. 


L. ISRAEL 


MRS. 


E. 


KAHN 


MRS. 


C. 


MC LANE 



WE ARE GRATEFUL TO THE FOLLOWING 
SPONSORING COMMERCIAL CONCERNS 

CIBA PHARMACEUTICAL PRODUCTS, INC. 
INTERNATIONAL BUSINESS MACHINES, INC. 
SCHERING CORPORATION 
THE UPJOHN COMPANY 



60 



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NEW YORK UNIVERSITY POST -GRADUATE MEDICAL SCHOOL 

Departments of 
Obstetrics, Qynecology and Urology 

COURSE NO. 564-A - INFERTILITY 
December 8 through iO, 1952 

UNDER THE DIRECTION OF DR. LOCKE L. MACKENZIE AND DR. ROBERT S. HOTCHK I SS 

Tuition: $^0 • 



I 



ALL SESSIONS IN ERDMANN AUDITORIUM. UNIVERSITY HOSPITAL 



303 EAST 20TH STREET N.Y.C. (UNLESS OTHERWISE NOTE) 



MONDAY. DEC. 8 

8:45 9: 15 a.m. 
477 First Avenue 

9:15 - 10:00 a.m. 

10:00 - 11:00 

11: 00 a.m. - 12 noon 

12:00 - 1: 00 p m. 
l: 00 - 2: 00 p.m. 



2:00 - 3:00 p.m. 
GYN Clinic 

3:00 - 4:00 p.m. 



4:00 5:00 p.m. 



5:00 - 6:00 p.m. 

TUESDAY. DEC. 9 
9:00 - 10:00 a.m. 



10: 00 - 11:00 a.m. 



11:00 a.m. - 12:00 noon 



12:00 - 1:00 p.m 



Regi st rat ion 



Introductory Lecture 
Dr. Locke L. Mackenzie 

Physiolop^y of Ovulation 
Dr. Maxwell Roland 

Physiology of Menstruation 
Dr. Theodore Neustaedter 

Lunch Hour 

Technique of Tubal Insufflation 
Dr. Ernest Myller ^y 

Performance of Tubal Insufflation 
Dr . Maxwe l l Roland 

Fundamental Con si derations of the 
Anatomy and Physiology of the Male 
Genital System 

Dr. Robert S. Hotchkiss 

Hi Story Taking and Physical Examination 
in the Male 

Dr. Robert 5. Hotchkiss 

Cervical Incompatibi li ty 
Dr. Locke L. Mackenzie 



Physiology of Ferti li zation and 
Nidation 

Dr. Maxwell Roland 

Other Endocrine Factors Involved in 
Infertility 

Dr. Theodore Neustaedter 

Uterine Malposi tions, Fibroids, 
Ovarian Cysts and Cervical pathology 
as Factors in Infertility 
Dr. jyaZter T. Dannreuther 

Lunch Hour 



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Inferti lity 



Page 2 



) 



TUESDAY. DEC. 9 ( coTit inued) 
1: 00 2:00 p.m. 



2:00 - 5:00 p.m. 

GYN Cytology Laboratory 



5:00 - 6:00 p 



m 



WEDNESDAY. DEC. 10 
9:00 10:00 a.m. 



10:00 awm. - 1:00 p.m. 
GYN Cytology Laboratory 

1: 00 - 2:00 p.m. 

2: 00 - 3: 00 p-m. 
GYN Clinic 

3: 00 - 4: 00 p.m. 



4:00 - 4:30 p.m 



4:30 p.m 



Technique of Artificial Insemination 
Dr. Locke L* Mackenzie 

Techniques and Interpretation of 
Semen Analysis 
Drs. John MacLeod, Robert Hotchkiss 
and John Silberblatt 

Motion Picture on Semen Analysis 
Dr. Robert S. Hotchkiss 



Methods of Determination of the Time 
of Ovulation 
Dr , Locke L. Mackenzie 

Cytology of the Menstrual Cycle 
Dr. E. Lawrence Hecht 

Lunch Hour 

Performance of Hystero- salpingography 
Dr. Mortimer N. Hyams 

Surgery of Occluded Fallopian Tubes 
Dr. Locke L. Mackenzie 

Surgery of Male in Infertility 
Dr. Robert S. Hotchkiss 

Bound Table Discussion 



n 



New York University - Bellevue Medical Center 
University Hospital 
303 E. 20th Street 



New York 



Department of Gynecology 



Staff Conference 

Wednecday, December 15 f 19^0 



Doctor W.T.Dannreuther, Executive Officer 



tophitheatre "»" at i(^:00 p.n* 



1. Introduction of a New 
Instrument 

2. Report of a Gase of 
Puberty Bleeding 

3. Presentation of a Gase 
of Papillomata of the 
Bladder 

4^ Presentation of a Gase 
of Mesenteric Thrombosis 
Complicating Pregnancy 

5, Report on Ectopic Pregnancy 



Doctor Ernest l^ller 



Doctor Theodore Neustaedter 



Doctor Robert Gushing 



Doctor Henry MacDuff 



Doctor Michael Jordan 



ii 



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AMERICAN BOARD DF DBSTETRICS AND GYNECDLDGY 



Dr. Walter T. Dannreuther, New York. PraideiM 
Dr. Joseph L. Baer, Chicago, III., Vice President 
Dr. L. E. Phaneuf, Boston, Mass., Vice President 
Dr. Paul Titus, Pittsburgh, Pa., Secretary-Treasurer 
Dr. E. A. Schumann, Philadelphia. Pa. 
Dr. L. A. Emue, San Francisco, Calif. 
Dr. Norman F. Miller, Ann Arbor, Mich. 
Dr. Willard R. Cooke. Galveston. Texas. 
Dr. f. Bayard Carter, Durham, N. C. 



f AGS \ 
AAOG&AS 

\ AMA ; 



OFFICE OP THE SECRETARY-TREASURER 

DR. PAUL TITUS 

1015 HiGHLAND Building 

Pittsburgh, Pa. 

October 2, 1947. 



TO APPLICANTS OP THE AMERICAN BOARD OF OBSTBTRICS AND QYNECOLOGY: 



It is noted from your application for admission to the exam- 
inations of the Board that you are of foreign birth, and I regret to 
advise you that it will be necessary for you to furnish us with a not- 
arized Statement regarding your citizenship in either the United States 
or Canada, since the Board has a ruling that it cannot accept for ad- 
mission to exaraination any oandidate who is not a füll Citizen of either 
the United States or Canada. 

This ruling beoame effective at the olose of the annual 
meeting of the Board on June 9, 1942, and applies to all applications 
received in this office after that date regardless of the date on which 
the original inquiry regarding application was made. 

I would suggest that you have prepared by a notary public a 
Statement that he has seen your papers and that they are in Order, at- 
testing to your füll citizenship in the United States or Canada, or if 
your citizenship was attained through your parents' papers when you 
were a minor, attested proof of this. Do not send citizenship papers « 

We regret greatly that it is necessary to write you about 
this matter, but it is required that we have such Information for our 
permanent files« 



Yours very truly, 



PTiA 



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AMERICAN BOARD DF DBSTETRICS AND GYNECDLDGY 



Walter T. Dannrbuthbii, M. D„ New York. Prtsident 

Joseph L. Babr. M, D., Chicago, Iu... Vice President 

Ludwig A. Emoe, M. D., San Francisco, Calif., Vice President 

Paul Trrus, M. D., Ptttsburgh, Pa., Secretary-Trtaturer 

NoRUAN F. MnxER, M. D., Ann Arbor, Mich. 

Willard R. Cooks, M, D.. Galvbston, Texas. 

F. Bayard Carter. M. D., Durham, N. C. 

Edward A. Schumann, M. D., Philadblthia, Pa. 

Robert L. Faulkner, M. D., Clbvbland, Ohio. 




OFFICE OF THE SECRETART-TREA8URER 

PAULTITUS, M.D. 

1015 Highland Building 

PiTTSBUROH 6, Fa. 



April 27, 1948, 



Dear Doctor Myller: 

The Credentials Committee of this Board directs me to inform you 
that you are eligible for admission to the Part I examination of this Board to 
be held in 19U9, or at ary regularly scheduled Part I examination within three 
years of the date of filing your application. 



Part I - 



The examinations of the Board consist of two parts: 

(a) Written examination, to be held on the first Friday of each 
February in various cities of the United States and Canada» 
Arrangements will be made for you to report for the Part I 
written examination at or near your place of residence» 

(b) Under a recent change in regulations; case report s to be reviewed 
should be scnt to the Office of the Secretary as soon as 
possible after receipt of this notice of eligibility. In making 
acknowledgment of this notice, the Secretary should be notified 
of the apprjximate date on which the case reports may be expected» 
This date should not be more than thirty (30) days after the date 
of the eligibility notice, and none may be submitted after the 
date of the scheduled Part I examination in Februaiy except by 
special arrangement. Candidates cannot proceed to Part II examina- 
tions until c\fter Part I has been successfully conqpleted. 

Part II - - An oral-clinical and pathology examination, following completion 

of the Part I examination at a subsequent meeting of the entire 
Board. This examination is usually held immediately prior to, and 
at the place of , the annual Convention of the American Medical 
Association, but may be scheduled elsewhere« 

Information as t o the dates and exact location of these examinations 
will be published in State medical Journals and The Journal of the American 
Medical Association» Notices will be sent you well in advance of the examination 
dates» 

Your examination fee of $»85 «00 is now due« Please make your check 
payal>le io the American Board of Obstetrics and Gynecology. 



Ernest Myller, M. D. , 

875 Park Avenue, 

New York 21, New York. 



pVadf JUL 1 7 194a 



Veiy trjüy yours, ^ . 



Paul Titus, M. D. 
S ec re tary-T re as urer 



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AMERICAN BOARD DF DBSTETRICS AND GYNECDLOGY 



/ 



Walte» T. Dannreitthek. M. D„ New York, President 
Joseph L. Baer. M, D., Chicago. Iu... Vice President 
Norman F. Miller, M. D., Ann Arbor, Mich., Vice President 
Paul Trrui. M. D., Ptttsburoh, Pa., Secretary-Treasurer 
WaLARD R. CooKE. M. D., Galveston, Texas. 
F. Batard Carter, M. D., Durham, N. C. 
Robert L. Faulkner, M. D., Cleveland, Ohio. 
Daniel G. Morton, M. D., San Francisco, Calu. 
R. A. Kimbrouch, Jr., M. D., Philadelphia, Pa. 



r AGS \, 
,AAOG&AS 
\ AMÄ / 



OFRCE OF THE SECRETARY-TREASURER 

PAULTITUS, M.D. 

1015 HiGHLAND Building 

Pittsburgh6, Pa. 



April 1, 1949. 



Ernest Myller, M. D,, 

875 Park Avenue, 

New York 21, New York. 

Dear Doctor Myller: 

The American Board of Obstetrics and Gynecology 
directs me to inform you, which I do with pleasure, that 
you have attained a satisfactory grade in your written 
examination and in your case histories, 

You are now eligible for the final examination, 
Part II (oral and pathology) which will be held at the 
Hotel Shoreland, Chicago, Illinois, May 8 to 14 inclusive, 
1949, Notice of your examination assignment, from which 
you will have dates for making hotel reservations , is 
either enclosed herewith or will be forwarded to you soon« 

Very truly yours, 

. ; ^^ - 

Paul Titus, lU ^. , 
Secretary* 

PTadf 



n 



AMERICAN BOARD DF OBSTETRICS AND GYNECDLDGY 



Waltb» T. Dannmuthe», M. D„ New York, Praident 
Joseph L. Baem. M, D., CmcAOO. lu... Vice President 
NoEMAN F. Miller. M. D.. Ann Arbor, Mich.. Vice President 
Paul Tirut. M. D., Pittsburoh, Fa., Secretary-Treasurer 
Willard R. Cooke. M. D., GALVEtroN, Texas. 
F. Batard Carter. M. D., Durham. N. C. 
Robert L. Faulkner. M. D., Clevbland, Ohio. 
Daniel G. Morton, M. D., San Francisco, Caue. 
R. A. KiuBROUGH. Jr., M. D.. Philadelphia, Pa. 



f AGS ^^, 

AAOG&AS, 
. AMA / 



OinCE OP THE SECRETARY-TREASURER 

PAULTITUS, M.D. 

1015 HiGHLAND Building 

Pittsburoh 6, Pa. 



May 19, 1949* 



Emest Myller, M, D. , 

875 Park Avenue, 

New York 21, New York. 

Dear Doctor Myller? 

The American Board of Obstetrics and Gynecology directs rae to 
inform you, which I do with pleasure, that you have successfully passed 
the examinations for certification« 

Please fill out and retum the enclosed slip to this office so that 
your certificate may be properly inscribed. The certificate will be 
forwarded to you within the next fev/ months. 

In giving us the infonnation for yoiir certificate and for yovir listing 
with the Board, will you advise us if you maintain more than one office, 
and wish more than one listing in the geographical list of Diplomates« TUTe 
will appreciate also if you will advise this office promptly at any time 
that your address is changed. 

It is the sincere hope of the entire Board that you will continue 
your active interest in the work of the Board, and your suggestions will 
be welcome at all times« 

Cordial^Ly yours, 

Paul Titus, M. 1)., 
Secretary. 

PTadf 

encl - certificate slip 



•^ 



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Tbl. PLAZA 5-1274 



UNITED STATES A INTERNATIONAL 
PATENTS ft TRADE MARKS 



registered 



ARMAND E. MESTERN 

PATENT ATTORNEY 

565 FIFTH AVENUE 

New York 17. N. Y. 



Dr. Ernest MyLLer, 
875 Park Avenue, 
New York, N.Y. 



Sept. 16, L949 



re:lnsuff lation Cannula 



\ 



Dear Dr. Ilyller: 

I have pleasure to enclose the document 
relatlng to the patent issued in the above matter, 

The number of the patent is: 

2^480,041, 

The j^atent Is dated: 
August 23, 1949 

The term of the patent is 17 yeare from 

the Said date. The patented artioles should be marked; 
U.S.Patent 2,480,041. 

Please acknowledge recei^^t and oblige 



AEM/APA 
enc. 




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tV.^.'W'j«- 



,^. ^- -^ 



f^ 




7 



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No./ 

Massachusetts 






Board of Registration in Medicine 

As a means of identifying applicanta to 
practice mediciiie, two unmounted finished 
photographs (not proofs), 3^x4%, of each 
applicant must be furnished, one of which 
shall be certified by the Dean of the Medical 
College (see note) which he attended and t^e 
other shall be marked with the niimber assign- 
ed to the candidate and shall be returned to 
him with his card of admission. Each ap- 
plicant must bring the returned pho- 
tograph to the Board of Examiners on 
the morning on which he takes his 
first examination; otherwise the ap- 
plicant will not be admitted to the ex- 
amination. Cap and gown photographs 
and snapshots are not accepted. 

Photograph to be presented at each ex- 
amination by displaying same upon table when 
writing. 

This blank should be pasted on the un- 
mounted photograph which is to be returned 
to the applicant with the card of admission. 

^•. \ 



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DR. ERNEST MYLLER 



H 



Am 23. Oktober starb im 60. 
Lebensjahr infolge einer Herz- 
attacke der bekannte Gynäkologe 
Dr. Ernst Myller, der in New 
York am Madison Avenue und 
University Hospital tätig war. In 
Schmalkalden geboren, studierte 
er Medizin an der Univerlität von 
Berlin und wirkte bis zur Macht- 
übernahme der Nazis an einem 
Spital in Nürnberg. Danach wan- 
derte er nach Griechenland aus, 
wo er in Athen ein Spital grün- 
dete, dem er sieben Jahre lan^ 
vorstand. 

Neben seiner ausserordentlich 
erfolgreichen medizinischen Wf- 
tigkeit — er war Arzt der ameri- 
kanischen und britischen Bot- 



schaft und des Königs von Grie- 
chenland — stellte er sich nach 
Kriegsausbruch den Alliierten zur 
Verfügung und arbeitete für das 
British Intelligence Service. Als 
die Deutschen 1941 in Griechen- 
land einfielen, evakuierten die 
Engländer Dr. Myller und seine 
FamlM^ auf einem britischen 



Kreuzer. Dr. Myller ging nach 
den Vereinigten Staaten und liess 
sich in New York nieder. 

Er hat zahlreiche wissenschaft- 
liche Arbeiten auf gynäkologi- 
schem Gebiet veröffentlicht und 
auch Instrumente entworfen, da- 
runter solche zur Feststellung 
von Gebärmutterkrebs. Er war 
Sekretär der Rudolf Virchow Mc- 
«»1 Society und Chairm«in der 
onference of the Obstetrical 
oard of Madison Avenue Hospi- 
Tal sowie Mitglied verschiedener^ 
wissenschaftlicher Verein! jungen. 
Dank seiner grossen Hilfsbe- 
reitschaft, Liebenswürdigkeit und 
Pcscheidenheit erfreute sich Dr. 
Myller besonderer Beliebtheit bei 
allen, die ihn kannten. Er wird 
von seiner Frau, Liselotte, und 
einem Sohn, Ralph, überlebt. Sein 
zweiter Sohn, Lieutenant Ulrich 
Myller, ist vor drei Monaten in 
Korea gefallen. 



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Ittjprinted liom NEW YORK STATE JOURNAL OF MEDICINE, Vol. 50, No. 3, Feb. 1, 1950 

Co})yrig}it 1950 l)y the Medical Society of the State of New York and reprinted by permission of the 

Copyright owner. 

A CERVICAL "SCRAPER" 

Ernest Myller, M.D., New York City 

{From the Universüy Hospital, New York Universüy-Bellevue Medical Center) 



PAPANICOLAOU'S detection of exfoliated 
Cancer cells in the vaginal smear has added 
greatly to the early recognition of malignant dis- 
ease. The present method of scraping the cer- 
vical canal in order to obtain a greater concen- 
tration of Cancer cells, and especially more cells 
from the cervical epithelium, is considered an 
improvement over the simple vaginal smear. 
The important region to be investigated is the 
junctional region between the columnar cell 
epithelium and the squamous cell epithelium, 
since the majority of cervical Cancers originate in 
that area. The detection of Cancer of the cervix 
and the fundus at the earliest possible moment 
will increase the curability of this disease to a 
considerable degree. The well-founded assump- 
tion that a noninvasive Carcinoma may be present 
intraepithelially for many years without any 
Symptoms and without progress justifies an 
examination of every adult woman by the vaginal 
smear method or with a cervical scraping, or 
both. 

A simple instrument, the cervical "scraper," 
facilitates obtaining satisfactory specimens with 
every routine vaginal examination . * This instru- 
ment consists of a small metal cone attached to a 
handle (Fig. 1). On both sides of the cone there 
is a fin (Fig. 2) . These two fins converge on the 
top of the cone. The free sides of the fins are rec- 
tangular but not sharp. When used properly 
no trauma occurs; only epithelial cells will be 
scraped off. Satisfactory smears can be obtained 
by an examiner without previous experience. 





Fig. 2. 



Fig. 3. 



-Ä 



SS 



Fig. 1. 

After exposure of the cervij^ with a speculum, 
the cone is inserted into the cervical canal and 
rotated once or twice with very slight pressure 
(Fig. 3). Occasionally, suspicious areas outside 
the canal should also be scraped off with the top 
of the instrument where the two fins join. The 
epithelial cells will adhere to the fins, and the 



material thus obtained is transferred to glass 
slides by smearing it from the fins directly on 
the slides. The slides are immediately immersed 
in the fixative Solution. 

The conical shape of the cervical "scraper" 
prevents its deviation from the longitudinal axis 
of the cervical canal; the scraper is bound to 
come in contact with the epithelial junction line 
whether the cervix is small or large. 

The cervical * 'scraper" is easily sterilized and 
can be used repeatedly to obtain cells from the 
cervix. In comparing smears taken with this 
scraper and with disposable wooden spatulas, it 
appears that more sheets of well-preserved cervi- 
cal cells are obtained with the former with little 
or no bleeding. The instrument penetrates as 
easily into the nonparous cervical os as into a 
lacerated, diseased cervical canal. 






* Manufactured and diatributed by United Surgical Supply 
Co., 160 East 56 th Street, New York City. 



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I-e ; Dr Sl^Oi^'r LYLliSR . 



?o ;/lioi. it i.ay concern. 



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Avenue, llev^ York 2I,::»Y. ,v;as est^blis}.ed in Athens fron 1 934-1 941, 
Vhile here he^ directed a ^n^cGloGical-obstetrical Clinic.;, 
estiration ho \ms one. of the best {^^necolo^ists and obstetrlclans 
in Athens. I consider liir. an ercellant physician and sur^eon; I 
liave liad the opoortuuity to follor liic Operations and have seen 
eycellent reGults. 



1mm 



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.OaLU ^ 

I. erber of tKe Agadex-iy /'"Athens , 
Cliaiman of the Syprer.e IDsltli Council and 
Pi-ofensor o^f the l'edical 7aculty in thB^l'niversit: 
of Athens; > 



Athens, 30 th GeptCL.ber Iö46. 






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Reprinted, with additions, from The Journal of the American Medical 
Asswialion. June 21, 1952, Vol. 149, pp. 757 and 758 

Copyright, 1952, hy American Medical Association 



CONTROL OF POSTPARTUM HEMORRHAGE 



Ernest Myller, M.D., New York 

Hemorrhage is one of the most frequent causes of 
Postpartum death. Statistics being reliable only from 
larger Hospitals, we may assume that many Postpartum 
deaths are either unreported or designated otherwise. 
In a report from the Mayo Clinic,' the incidence of 
death from hemorrhage is 0.491 per 1,000 births, an 
average of 1 case per 2,000 deliveries. Postpartum hem- 
orrhage in a large Brooklyn hospital caused death in 34 
of 37 cases of obstetric fatality. It can only be conjectured 
how many more occur in institutions with lower Stand- 
ards. 

There are Standard methods of treating postpartum 
hemorrhage. It must be assumed from the poor results 
reported that they are not always successful. The usual 
routine procedure is to endeavor to find out whether the 
Uterus is empty or to establish other causes for the bleed- 
ing. By the time the examination is completed, the hem- 
orrhage may become alarming. Posterior pituitary 
(Pituitrin*) or ergot is given intravenously, the uterus is 
massaged, and in many cases valuable time is lost. Intra- 
uterine packing is resorted to, which stops the bleeding 
for the moment. Blood transfusions are started. After a 
Short time the bleeding may start again, seeping through 
the packing. Removal and reapplication of packing does 
not necessarily stop the bleeding and, in spite of con- 
comitant transfusions, the patient may rapidly become 
moribund. It is the belief of Douglass - that when the 
first uterine packing is not successful, the uterus is prob- 
ably ruptured. If such is the case, a second packing is 

From the Department of Obstetrics and Gynecology, New York Uni- 
versity Medical College. 

1. Hunt, A. B.: Massive Obstetric Hemorrhage Rcquiring Hysterec- 
tomy. Am. J. Obst. & Gynec. 49:246-252 (Feb.) 1945. 

2. Douglass, L. H., in discussion of Beacham, W. D., and Beacham, 
D. W.: Rupture of the Uterus, Am. J. Obst. & Gynec. 61 : 824-837 (April) 
1951. 



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definitely contraindicated. Greenhill ' also advised 
against packing the Uterus a second tinie, recommending 
immediate hysterectomy as the safer procedure. 

Postpartum hemorrhage can be controUed, no matter 
what its cause, by a method described many years ago by 
Logothetopoulos in Athens.' His method involves a type 
of packing that he originally used after clamp hysterecto- 
mies. It was inserted into the pelvis after the Uterus was 
taken out, allowing immediate removal of the clamps 
without any loss of blood. Logothetopoulos applied the 
same principle of hemostasis to control of bleeding from 
the Postpartum uterus after considerable experience in 
his surgical cases had proved it efficient. He called the 
procedure ''traction packing." 

METHOD 

A doubly folded quadrangular piece of gauze 36 in. (91 cm.) 
Square and a gauze roll 4 in. (10 cm.) wide and 16 yd. (15 m.) 
long are required. The Operator grasps the cervix with one or 
several tenaciilum forceps and brings it down well to the level of 
the Vulva. The blades of a vaginal speculum are helpful in 
spreading the cervical canal apart. The center of the quad- 
rangular piecc of gauze is inserted into the Uterus by means of 
a sponge forceps. In contrast to the conventional method, it is 
not necessary to reach the fundus with this packing. 

The four corners of the quadrangular piece of gauze protrud- 
ing from the uterus are spread apart. The Operator then packs 
the long Strip of gauze into the gauze sack situated in the uterus. 
Carefully done, this produces a large round ball inside of the 
Uterus. The size of this ball is always the same, being deter- 
mined by the uniform amount of gauze strip used. Thus the 
whole procedure bccomes automatic and not subject to indi- 
vidual alterations, an important point in an Operation when 
time means everything. 

The four corners of the quadrangular piece of gauze are 
grasped in one band and pulled downward. The blood supply of 
the Uterus is cut off and bleeding ceases at once. In order to 
maintain the downward traction, the gauze stem is run through 
a thick ring pessary, and the pessary is pushed upward against 
the Vulva, which is protected by a piece of gauze. The ring is 
fixed in its position with a clamp. 



3. Greenhill. J. P.: in Yearbook of Obstetrics and Gynecology, Chi- 
cago, The Yearbook Publishers, Inc., 1950, p. 241. 

4. Logotiietopulos, K.: Gynäknelogische Chirurgie, Berlin, Julius 
Springer, 1939 



Conventional packing is an attempt to compress the 
open sinuses and blood vessels in the wall of the bleeding 
Uterus. To be sure, the packing itself may produce a 
contraction, and only in such cases will it be effective. 







Fig. 1. — Insertion of the quadrangular piece of gauze into the uterine 
cavity. 




Fig. 2. — Spreading the quadrangular gauze and filling it with a gauze 
Strip. 

On the other hand, traction compresses the uterine ves- 
sels against the pelvic wall, interrupting the blood flow 
to the Uterus completely. If the uterus is atonic, there 
is in addition to this hemostatic efl'ect the oxytocic 



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Fig. 3. — Downward traction applied to four corners of the quadrangular 
piece of gauze. 




Fig. 4. — The stem of gauze pulled through a ring pessary 



eflfect of anemia, which is produced by compression of 
the arteries. Furthermore, it is possible that pressure 
upon Frankenhauser's ganglion stimulates the uterine 
muscle to contract by way of the autonomic nerves. It 
is obvious that the cause of the bleeding does not in- 
fluence the effectiveness of this packing. Wherever the 
bleeding comes from, it will be stopped. This packing is 
inserted with relative ease, far more readily than a con- 
ventional packing, with no need to fill the uterine cavity 
completely, and the procedure is rapid and precise. 




Fig. 5. — Packing in situ and maintenance of traction by application of 
a strong clamp. 

This packing is indicated only in cases of severe hem- 
orrhage, after simpler procedures have been attempted 
and the vagina and cervix examined as possible sources 
of bleeding. Its purpose is to control bleeding immedi- 
ately and to eliminate anxiety and haste. Once accom- 
plished, additional measures such as transfusion and con- 
sultation may be obtained in leisure. As the patient's 
condition improves with or without transfusion, the sub- 
sequent procedure depends upon diagnosis. If the Uterus 
is atonic and the bleeding has stopped entirely, the pres- 
sure is released by opening the clamp. After a short while 
the internal strip of gauze may be gradually removed, 






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followed by the quadrangular piece of gauze, which may 
take out with it pieces of membrane left behind. The 
removal of the packing is almost painless. 

If the hemorrhage has occurred after a difficult forceps 
delivery, a version, or in a case in which a cesarean 
section has been done previously, the possibility of a 
ruptured Uterus must be considered. In this instance the 
packing may enter the abdominal cavity through the tear 
in the uterus, intentionally or by chance. No härm can 
be done by the possible additional trauma to the uterine 
wall, since it will be necessary to remove the uterus any- 




Fig. 6. — Compression of the hypogastric vessels when traction is 
applied to the gauze packing. 

way. Once in place, traction packing allows time for 
carefui preoperative preparation. There is no urgency 
for any operative Intervention while the patient is in 
shock. Her chances for recovery after hysterectomy or 
more conservative procedures are much improved. 

According to Greenhill, the mortality rate of uterine 
rupture is 58%. A very recent report from the Harlem 
Hospital ^ gives the mortality rate as 57.1%. Consider- 
ing the excellent facilities and expert attention in this 
hospital, it may be assumed that in less well-equipped 

5. Posner, L. B.; Smith, D. F., and Trambert, H. L.: 14-Year Survey 
of Parturient Ruptured Uterus at Harlem Hospital, New York J. Med. 
51:641-644 (March) 1951. 



institutions the mortality rate may be much higher. With 
successful hemostasis and eliminated urgency, with time 
to recover from shock, mortality rates should be con- 
siderably reduced. Posner and his co-workers •' stated, 
"Immediate transfusion and laparotomy, regardless of 
the degree of shock, is the surgical treatment of rupture 
of the Uterus." Speaking of mortality, they add that with 
adcquatc blood transfusion and present-day antibiotics 
all natients might have survived. All these ends can be 
realized with traction packing; there is no need of im- 
mediate Operation "regardless of the degree of shock." 
Actual experience with this packing is limited. Logo- 
thctopoulos has used it in only about 10 cases of Post- 
partum hemorrhage, but has had excellent results in all. 
This packing procedure was studied in cadavers at the 
University of Athens." The packing was inserted in the 
manner described, followed by traction. A dye was in- 
jected into the carotid artery under pressure and there- 
after the pelvic organs were examined. All blood vessels 
except the uterine arteries were filled with the dye. It 
was interesting to note that the Ureters were not com- 
pressed; they could be flushed through from above with 
very slight pressure. 

SUMMARV 

There are few new methods available to reduce the 
mortality rate of Postpartum hemorrhage. Blood trans- 
fusion is often unsuccessfui because hemostasis is diffi- 
cult. Operations are often done with the patient in shock. 
Traction packing controls all Postpartum bleeding im- 
mediately and therefore should reduce the mortality rate. 

65 E. 76th St. 



6. Christopulos. C: Anatomische Ergebnisse der Biutstillungsmethode 
nach Logothetopulcs, Zeniralbl. f. Gynäk. 57: 807-809 (April) 1933 



PrinteJ and Published in the United States of America 



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NEW YORK UNIVERSITY-BELLEVUE MEDICAL CENTER 

OF NEW YORK UNIVERSITY 

UNIVERSITY HOSPITAL 

(FORMERLY NEW YORK POST-GRADUATE HOSPITAL) 
303 HAST TWENTIETH STREET NEW YORK 3. N.Y. 



EDWARD M. BERNECKER. M.D., Administrator 



GRamercy 7-2000 



March 2A, 1953 



Ernest IfyHer, M.D. 
6$ East 76th Street 
New York, New Yerk 

Dear Doctor ^fjrller« 

Thank you very imich for submltting the questions fer the exaMination 
•f the fereign physicians this Coming Friday. I hope you will not feel 
disturlbed that I have not used them. Macy nore were received than could be 
used and those whose were not selected there^y escape the onerous task of 
correcting the papers. I shall file your letter for possible later examination. 

Miss Eskin has broijght to vay attention that the present Committee of 
three, to review requests for performing therapeutic alwrtions in this hospital, 
has served for over a year and should be changed, Consequently, I have asked 
Doctor Locke L. Macke nzie to serve as chaiman of this Special Committee and I 
wonder if you will be wiUing to be one of the other two meabers. The duties 
are not very heavy. They consist of reviewing the histories of an average 4-5 
cases on whom members of the staff wish to perfora therapeutic abortions, and 
either approving or disapproving them for this procedure. As you know, this is 
carried out anonymously and the decision is cownunicated to the attending surgeon 
\mder ny name« I hope you will be willing to undertake this task. 

Sincerely yours, 

Gray H. Twombly, M.D. 

Assoclate Director 

Department of Obstetrids and Gynecology 



GHT :nse 



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NEW YORK UNIVERSITY 

WASHINGTON SQUARE 
NEW YORK 3. N.Y. 



OFFICE OF THE VICE CHANCELLOR 
AND SECRETARY 



18 June, 1953 



Ify dear Doctor Hsrller: 

Tou are hereby advised that the Council of New York 
University has approved and confirmed the action of the Board of 
Trustes s of the New York Üniversity-Bellevue Medical Center in 
appointing you to the paxt time staff of the College of Medicine 
for the year beginning Jrxly 1, 1953 with the title of Glinical 
Instructor in Obste trics and Gynecology. 



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Very truly yours. 




Vice Chancellor 
, and Secretary 



Dr« Emest >^ller 
450 East 63d Street 
New Tork 21, New York 



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NEW YORK UNIVERSITY 

WASHINGTON SQUARE 
NEW YORK 3, N.Y. 



OFFICE OF THE VICE CHANCELLOR 
AND SECRETARY 



15 June, 1950 



}fy dear Doctor ><5rller: 

lou are hereby adviaed that the Council of 
New York üniversity, at a meeting held May 22, 1950, approved 
and confinned the action of the Board of Trustees of the 
New Yoric Üniversity-Bellevue Medical Center is appointing you 
to the part tiae staff of the Post-Graduate Medical School for 
the acadeaic year 1950-1951, beginning September 1, 1950, with 
the title of Clinical Instructor in Obetetrios and Gynecology« 



Very truly yours, 



■Xv^^^-w^-^^ö-^ 




Vice Chancellor 
and Secretary 



Dr. Emest Hyller 
88-35 Elfflhurst Avenue 
Elohurst, New York 



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•. R. 40I 




city of new york 
Department of Hospitals 



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HARLEM HOSPITAL 

136TH STREET AND LENOX AVENUE 

NEW YORK SO, N. Y. 



May 16,1952 



Dr.Emest I^ller 

65 East 76th, Street, 

New York,N.Y. 

Dear Doctor I^ller: 

I wish to thank you on behalf of the 
Obstetrical Staff for your excellent presentation on 
uterina packing, at oiir last monthly Conference, 



With best wishes, I am, 




y yoixrs. 





ACP/M 



A.Charles Posner, M.D, "^^^ 

Director of Obstetrics 






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NEW YORK POST-GRADUATE MEDICAL SCHOOL AND HOSPITAL 

a03 EAST 20TH STREET, AT SECOND AVENUE 
NEW YORK. 3. N. Y. 



OUT-PATIENT DEPARTMENT 



GRamercy 8-7080 



January 2B, I^^^? 



To Whnm It ?/iav Cancern: 



Dr. Ernest Myller has beer, ass^ciated with th? Gynecological 
Staff of the P'^st Graduate Hospital for the past 5 years, 

During the past 4 years he has been associated with my clinic« 
I have found him to be competent and skillful in Gynecological 
diagnosis and treatment. 

He has an agreeable personality and works well with the 
other raembers of the staff. 




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DR ROBERT J LOWRIE 

I40 EAST FIFTY-FOURTH STREET 

NEW YORK 22, N.Y. 



November 29, 1950 



Dr. Emest ^^yller 
65 East 76th Street 
New York, N.Y. 

Dear Doctor Ä^ller: 



RE: Offering technic of biopsy of 
the cervix by l^ller*s Cervical Scraper 
in Lowrie's GYNECOLOGY 



I have read with Interest your article on the Cervical Scraper 
in the February Ist, 1950 issue of the New York State Journal of Medicine. 
We are now reading galley proofs of our forthcoming two volume work 
in gynecology and we have a chapter (Äevoted to Methods of Biopsy in volume 
II which is on gynecologic surgery. 

We are anxious to have our work up to .the minute so to speak, 
and for this reason we would like to include a picture of yoim Instrument 
with the Script in the form of a legend. At this late date trith the type of 
the book about half set up in print, we are more or less limited to 
making any additions in the form of legends. In our work we are using 
the legends pretty much exclusively to describe technic and we find it 
to be very satisfactory. 

On the Chance that you would give us consent to reproduce your 
technic with your figures 2 and 3, I have prepared the enclosed material. 
If you give us consent for reproduction, then will you i.iake any corrections 
in pencil and return your corrected sheet to me. Do you have the original 
illustrations of figures 2 and 3, If not, we could get permission from the 
manufacturer to loan the electros or cuts to our publisher. 

Because of the proximity of the date of publication, we should 
appreciate an early reply from you, and would thank you for such Coopera- 
tion as you may see fit to extend. Could you spare us two reprints. 





Robert J . Lowrie \ 
Editor-in-chief -^ 

P.S. Our publisher is Charles C. Thomas, 321 East Lawrence Avenue, Springfield, 
Illinois. In our two volume work there are 66 contributors from 30 medical 
schools in the United States, Canada and England. Volume II is devoted to 
Gynecologic Surgery. As of this date over half of the galley proofs are 
corrected. 



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JAMES F. McKERNON, M.D. 
Honorarv President 

ARTHUR F. CHACE, M.D. 
Pretident 

EDGAR H. BOLES 
VicB'President 

WILLIAM V. GRIFFIN 
Vice-President 

DAVE H. MORRIS 
Vice-President 

ALLEN WARDWELL 
Vice-Preaident 

ROBERT E. ALLEN 
Treaturer 

GEORGE A. VONDERMUHLL 

Secretary 

HELEN L. WATTS 
Assistant Secretary 



NEW YORK POST-GRADUATE MEDICAL SCHOOL AND HOSPITAL 

505 EA8T 20th STREET, at SECOND AVENUE 

NEW YORK 



June 23, 19A3 



Dear Doctor ^Jy-ller: 

I have the honor to advise you that, on the nomination 
of the MedicuL Board, you have been appointed by the Board of 

Directors of the New York Poöt-Graduate Medicul School and 
Hospital to be 

Junior Assistant Gynecologist to the Dispensary. 

This appointment takes effect as of May i, 19^43, 
and will remain effective at the pleasure of the Board of Directors 
until further notice« It is a temporary appointment until six 
months after the war ends, at which time it may be made peniianent. 

By authority of the Board of Directors, 




George A. Vonderaiuhll 
Secretary 



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Dr. Ernest lyjyller 
UO East 6lst Street 
New York, N.Y. 



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COLUMBIA UNIVCRSITY 
NEW YORK POST-GRADUATE MEDICAL SCHOOL 
303 EA8T 20TH STREET 
NEW YORK 



OFriCC OP THC DIRECTOR 



Oc tober U, 19^2 



^ ( 



Dr. Emest MJyller 
^0 East 6l8t Street 
New York 

Dear Doctor Myller: 

It gives me pleasure to inforia you that upon the 
recommendation of Dr. Walter T. Darmreuther, Executive 
Officer of the Department of Gynecology, you have been 
appointed Provisional Assistant to the Dispensary in that 
department for a period of six months, beginning November 
1, 19^2, 

A copy of our Directory of the Staff is being sent 



to you under separate cover 



THRiom 



Very truly yours, 

Thomas H. Busseil, M.D. 
Assistant Director 




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PHONI TRaffolgcr 9-1100 



MADISON AVENUE HOSPITAL 
30 EAST 76th STREH 
NEW YORK 21, N. Y. 



Dr. E. Myller 
65 R. 76 St, 
New York City 



Dear Doctor: 

The Obstetrical Department of the Madison Avenue Hospital 
cordially invites you to attend its regulär quarterly 
DIMN^:3^ MSFTINH to be held on the 15th floor of the hcspital 
at 8 P.y.. on V^^olnesJay, June lOth 1953 , 

PROGRA.M 
Maternal and fetal death statistics for the past three months 



SCIENTIFIC PROORAli! 



!• Carcinoma In Situ In Pregnancy, 



Ernest Myller,M.D. 



2, IJterovaginal Extirpation For Procidentia, 

(Motion picture) Charles H,Thom,M.D. 



Dinner: 8 P.M. 
R.S.V.P. 



Sinoerely yours. 



^y4/y^ ^^^^^^^-^-^ty ^J>^ 



Geza Weitzner, M.D. 



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NEW YORK UNIVERSITY 

WASHINGTON SQUARE 
NEW YORK 3, N.Y. 



OFFICE OF THE VICE CHANCELLOR 
AND SECRETARY 



10 Jiine, 19^9 



i 



}fy dear Doctor Myller: 

You are hereby advised that the Council of 
New York üniversity, at a meeting held May 23, 19^9, approved 
and confirmed the recommendation of the Board of Trustees of 
the New York Üniversity-Bellevue Medical Center that you be 
appointed to the staff of the Post-Graduate Medical School 
for the academic year 1949-1950, beginning September 1, 194-9, 
with the title of Clinical Instructor in Obstetrics and 



Gynecology, 



Very truly yours, 




Dr. Ernest Myller 
88-35 Elmhurst Avenue 
Elmhurst, New York 



Vice Chancellor 
and Secretary 




4f-ail>fe«ä«»t'lll>lll 'in ■»■ 



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NEW YORK UNIVERSITY 

WASHINGTON SQUARE 
NEW YORK 3, N.Y. 



OFFICE OP THE VICE CHANCELLOR 
AND SECRETARY 



20 June, 1952 



Ify dear Doctor Myller: 

You are hereby advised that the Counoil of New York 
University, at a meeting held May 26 ^ 1952, approved and confirmed 
the aotion of the Board of Trustees of the New York University- 
Bellevue Medlcal Center in appointing you to the part time staff of 
tho Post-Graduate Medioal ßohool for the year beginning July 1, 1952, 
with the title of Instructor in Clinical Obstetrics and üynecology* 

The period of this appointment has heen made ooterminus 
with the fiscal year of the Medioal Center and thus overlaps the months 
of July and August, 1952 inoluded in your current term of servioe. 



,i 



Very truly yours, 




Vioe Chanoellor 
and Score tary 



Dr. Emest i^yller 
450 East 63d Street 
New York 21, New York 



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.wiimwm**^ 



V .'. W 



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NEW YORK UNIVERSITY-BELLEVUE MEDICAL CENTER 



OF NEW YORK UNIVERSITY 

477 FIRST AVENUE, NEW YORK 16, N.Y. 

OREGON 9-3200 



BOARD OF TRUSTEES 

WINTHROP ROCKEFELLER. Chairman 

F. ABBOT GOODHUE. Vict Chairman 

LAWRENCE C. MARSHALL. Treaturer 

HARRIS A. DÜNN. Stcrttary 

GEORGE A. BROWNELL 

JAMES M. CECIL 

NEVIL FORD 

BERNARD F. GIMBEL 

CHARLES C. HARRIS 

O. V. W. HAWKINS 

RUSH H. KRESS 

SAMUEL D. LEIDESDORF 

CHARLES S. McVEIGH 

BAYARD F. POPE 

HERBERT L. SPENCER 



July 3, 1953 



EXECUTIVE OFFICBRS 

EDWIN A. SALMON. Dirrcfor 

DONAL SHEEHAN. M.D.. Attociatt Dirtctor 

CURRIER MCEWEN, M.D.. Dtm 

College of Medicin» 
ROBERT BOGGS. M.D.. Dean 

Pott-Craduate Medical School 
EDWARD M. BERNECKER. M.D. 

Hospital Adminiitrator 
EDGAR S. TILTON, Exteutivt Stcrttary 



Dear Doctor >tyller: 

Yoiu are hereby advised that the Board of Trustees at 
a meeting held in June 1953 approved and conf irmed your re- 
appointment to the University Hospital staf f as hereinafter 
set forth: / 

Title: Assistant Attending Obstetrician euad Gynecologist 
Period: Effective Jiüy 1, 1953 

It is understood that all staff appointments shall 
be for periods not in excess of one year, and shall terminate 
on June 30th of each year thereafter following the commence- 
ment of Service under the appointment, provided however, that 
all such appointments shall be subject to the right of the 
Board of Trustees to aodify or cancel the terms of service at 
any time in the event that conditions make such action desir- 
able, the decision of the Board as to the desirability of such 
action being final, 

Sincerely yours, 



/ ÄAAy^ 66cA^/ÖXc-X.t^ 



SecÄtary 
Board oä Trustees 



Doctor Emest Ntyller 
450 East 63rd Street 
New York 21, New York 



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ORTHO RESEARCH FOUNDATION 

RARITAN, NEW JERSEY 

December 11, 1952 



Dr. Emest Myller 
65 East 76th Street 
New York 21, New York 

Dear Dr. Myller: 

Thank« for the reprlnt. The technlque is clever; and if it is as 
effective as a first eid, as I think it is, should be widely adopted, 

We will be delayed for a couple of weeks in getting out the next batch 
of Salpix. Just made up a batch; but, altho\jgh the vials are auto- 
claved, sterility tests have to be made , This takree 2 weeks, 

December 23 to January 3 I shall be in Texas, 

With greetings to the epproaching Holiday Season and Best Wishes for 
the New Year, 



! 



Sinc^rely, 





Carl ö, Hartman 
Assoclate Birector 



CGHtdf 



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f 

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fiudolf Virrlfant i^rbiral i^orirtg in tl|p Olttg of S^rw forb 



president 
Dr. Max Jessner 
870 fifth avenue 

cor. 8ecretary 
Dr. Ernst M. Rosenbaum 

B WEST 86th STREET 

trea8urer 
Dr. Arnold T. Benfey 

so PARK TERRACE WEST 



DeoQxnber 5# 195^ 



Dr» Emest Myll«r 
63 Bast 76th Stret% 
New ^ork City 







Dear Dr. Mylleri 



I am happy to inform you that at the last meetlng 
of the Rudolf Virohow Medioal Society, you were 
eleoted Corresponding Secretary» 



Sinoeroly yours. 





UU^ , 



emr/aw 



Ernst M* RosenbauA, M«D» 
Cor« Secretary 



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ALL PRESrNTATIOlC OPJ^N TO GrilTTAL riSCUBSION 



NTW YORK ÜNirRSITY - DriX'VUT MFDICrX CENTTR 
Univeroity Hospital 
303 r.20th Street 
New York 



Depertnent of Obstetrics 
and Gynccolocy 

Staff Confrrencc 
Wednesdoy, Mnrch 18, 1953 



1* Service Report of Gouverneur 

Hospital 

2 t f^crvice Report of Üniversity 
Hospital 

3t Carcinona in Situ Associated 
with Pregnancy 



Anphitheatre "B" at 4*00 p^n. 



Doctor Gray H# Twonbly, Preöiding 



Doctor Franklin Reyner 



Doctor Arthur Porvey 



Doctor Ernest Ifrller 



• 



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NEW YORK UNIVERSITY POST- GRADUATE MEDICAL SCHOOL 
Departments of Obstetrics and Gynecology and Urology 

COURSE NO 564 A INFERTILITY 

December iO through 12. 1951 

UNDER THE DIRECTION OF DR. LOCKE L MACKENZIE AND DR. S. HOTCHK'SS 

Tui tion $^0 

GIVEN AT THE UNIVERSITY HOSPITAL. 303 EAST 20TH STREET. N.Y C 



Monday , Dec. iO 
8 ö 45 - 9:15 a, m . 
477 First Avenue 



Regi str ation 



9: 15 - 10^00 a.m. 
Erdmann Auditorium 



Introductory Lecture 
Dr. Locke L. Mackenzie 



10:00 - 11:00 a.m. 
Erdmann Auditorium 



Physiology of Ovulation 
Dr. Maxwell Roland 



11:00 a.m. - 12:00 noon 
Er dm an Auditorium 



physiology of Menstruation 
Dr. Theodore Neust aedter 



12:00 - 1:00 p.m. 



Lunch Hour 



V^' 



1>00 2:00 p.m. 
rdmann Auditorium 



2:00 - 3:00 p.m. 
GYN Clinic 



Technicfue of Tub al Insuffl ation 
Dr s Ernest Myller 

Performance of Tub al Insufflation 
Dr. Maxwell Roland 



3.00 ' 4:00 p.m. 
Erdmann Auditorium 



4 00 5 00 p.m. 
Erdmann Auditorium 



Fundamental Consider ations of the 
Anatomy and Physiology of the Male 
Genital System 

Dr. Robert S. Hotchkiss 

Hi Story Taki ng and Physical Examination 
in the Male 

Dr. Robert S. Hotchkiss 



5;00 ^ 6 00 p.m. 
Erdmann Auditorium 

Tuesday , Dec . ü 
9^00 - 10:00 a.m. 
Amph. B 



10 00 ' 11:00 a.m. 
Amph. B 



1] 00 a.m, - 12 00 noon 
Amph. B 



Cervical Incomp atibi lit y 
Dr. Locke L. Mackenzie 



Physiology of Fertili zati on and 
Ni dati on 

Dr. Maxwell Roland 

Other Endocrine Factors Involved in 
Inf er ti 1 i ty 

Dr. Theodore Neustäedter 

Uterine Malposi tions. Fibroids, 
Ovarian Cysts and Cervica^ Pathology 
as Factors in Infertility 
Dr. Walter T. Dannreuther 



12 00 1.00 p,m. 



Lunch Hour 



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Inferti lity 



Page 2 



Tuesday, Dec. H (continued) 
1:00 - 2:00 p.m. 
Erdmann Auditorium 



Technique of Artificial Insemination 
Dr. Locke L. Macken zie 



2:00 - 5:00 p.m. 

GYN Cytology Laboratory 



Techniques and Interpretation of 
Semen Analysi s 

Dr. John MacLeod 

Dr. Bobert Hotchkiss 

Dr. John Silberblatt 






5:00 - 6:00 p.m. 
Erdmann Auditorium 



Motion Picture on Semen Analysis 
Dr. Robert S. Hotchkiss 



Wednesday, Dec i2 
9:00 - 10:00 a.ra. 
Erdmann Auditorium 



10:00 a.m. - 1:00 p.m. 
GYN Cytology Laboratory 

1:00 - 2:00 p.m. 

2:Oo - 3 «00 p.m. 
GYN Clinic 

3:00 - 4:00 p.m. 
Erdmann Auditorium 



Methods of Determination of the Time 
of Ovulation 

Dr. Locke L. Macken zie 

Cytology of the Menstrual Cycle 
Dr. E. Lawrence Hecht 

Lunch Hour 

Performance of Hystero- salpingogr aphy 
Dr. Mortimer N. Hyams 

Surgery of Occluded Fal lopi an Tubes 
Dr. Locke L. Macken zie 



\ 



4:00 - 4: 30 p.m. 
Erdmann Auditorium 



Surgery of Male in Infertility 
Dr. Robert S, Hotchkiss 



4:30 p.m. 



Round Table Discussion 



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NEW YORK UNIVERSITY-BELLEVUE MEDICAL CENTER 



OP NEW YORK UNIVERSITY 

UNIVERSITY HOSPITAL 

(PORMERLY NEW YORK P05T-GRADUATE HOSPITAL) 
303 EAST TWENTIETH STREET, NEW YORK 3. N.Y. 



GRAMERCY 7-2000 



Dccember 3, 1951 



Ernest >fyller, M.D. 
65 East 76th Street 
New York, New York 

Dear ^octor JfyUer: 

On Monday, December lOth, between 1-2 p.m., I have 

schedTiled you for a talk on the Technique of Tubal Insufflation 

here, in the Erdmann Auditorium, I hope you will be able to 



discuss it at this time. 



Sincerely, 



jv^^— 



Locke L.^ckenzie, M.D, 

Acting Chairman 

Department of Obstetrics and Gynecology 



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EDITOR 
AUSTIN SMITH. MD. 

AssociATc Editors 
Johnson F. Hammond, M.d. 

GEORGE HALPERIN, M.D. 



(Zilie Sauntal nf Ü}t 
Ameriran Meixtul Aaaortattan 

535 Nnrll? flfarfaorti »trtti 
(Stlirago 10 



In your reply pleaie 
refer to these initialf 



JFH 



March 5, 1952 



Dr. Ernest Myller 
65 East 76th Street 
New York 21, New York 

Dear Doctor Myller: 

In preparing your paper entitled "Control 
of Postpartum Hemorrhage" for the printer, attention 
has been called to the number of illustratlons and 
we believe that figures 5 and 6 are sufflclent as 
illustratlons. With your perraission the remaining 
illustratlons will be omitted from THE JOURNAL, but, 
if you desire, they may be included in your reprints 
at your expense. 

Sincerely yours, 




JFH : ad 



[mond, M.D, 
Isociate Editor 






/ 



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IA/>\JC-^ 






«f^ 



/ 







< 






j^i u ^xJ y-^' " '^^^ ^-7 J3L ^^ 



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■>:-»»V«IP.IWJ> .. l < « aL« 



NEW YORK UNIVERSITY 

WASHINGTON SQUARE 
NEW YORK 3, N.Y. 



OFFICE OF THE VICE CHANCELLOR 
AND SECRETARY 



31 October, 1951 



]Ay dear Doctor Wbrller: 

You are hereby advised that the Council of 
New York University, at a meeting held October 22, 1951, 
approved and confirmed the recommendation of the Board 
of Trustees of the New York Üniversity-Bellevue Medical 
Center that your title be changed f rom Clinical Instructor 
to Instructor in Clinical Obste trics and Qynecology, as 



of September 1, 1951. 



Very truly 





Vice Chancellor 
and Secretaiy 



Dr. Emest Myller 
^50 East 63 Street 
New York 21, New York 



n 



NEW YORK UNIVERSITY-BELLEVUE MEDICAL CENTER 



OF NEW YORK UNIVERSITY 

477 FIRST AVENUE, NEW YORK 16. N.Y. 

OREGON 9-3200 



BOARD OF TRUSTEES 

WINTHROP ROCKEFELLER, Chairman 

SAMUEL A. BROWN. M.D.. Vic* -Chairman 

LEROY E. KIMBALL. Secrttary-Tttaturtr 

GEORGE A. BROWNELL 

HARRY WOODBURN CHASE 

HARRIS A. DÜNN 

NEVIL FORD 

F. ABBOT GO<X)HUE 

CHARLES C. HARRIS 

O. V. W. HAWKINS 

RUSH H. KRESS 

SAMUEL D. LEIDESDORF 

CHARLES S. MCVEICH 

BAYARD POPE 

JOHN M. SCHIFF 



OFFICERS OF ADMINISTRATION 

FDWIN A. SALMON. Director 
DONAL SHEEHAN. M.D.. Chairman 

Scientific Committm 
CURRIER MCEWEN. M.D.. Dean 

Colligt of Medicint 
ROBERT BOGGS. M.D.. Dean 

Pott-Craduate Medical School 
EDWARD M. BERNECKER. M.D. 

Hospital Adminittrator 
EDGAR S. TILTON. ExtcutttH Seccttarg 



October 22, 1951 



Dear Doctor llyller: 

You are hereby advised that the Board of Truste es at 
a meeting held October 16, 1951 approved and conf iraied your 
Promotion to the ühiversity Hospital staf f as hereinaf ter 
set forth: 

Title: Assistant Attending Obstetrician and Gynecologist 
Period: Effect! ve September 1, 1951 

It is understood that all staff appointments shall 
be f or perials not in excess of one year, and shall terminate 
on August 31s t of each year thereafter following the commence- 
ment of service under the appointment, provlded however, that 
ail such appointments shall be subject to the right of the 
Board of Trustees to modify or cancel the terms of Service at 
any time in the event that conditions make such action desir- 
able, the decision of the Board as to the desirability of such 
action being final. 

Sincerely yours. 



Secrel^ry-Treasurer 
(100 Washington Square East) 



Doctor Emest Myller 
63 East 76th Street 
New York 21, New York 



1 



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THE YEAR BOOM PU B IIS HERS, IN C, 

PUBLISHERS TO THE MEDICAL AND DENTAL PROFESSIONS • 200 EAST ILLINOIS STREET • CHICAGO 11, ILLINOIS 



July 8, 1952 



Ernest Myller, M. D. 
65 East 7^h Street 
New York, New York 



In reply please refer to Code G ^03 



Dear Dr. ^fyller: 



Dr, J. P. Greenhlll, the editor of the Year Book of Obstettics and 
Gynecology, has selected your article, Control of Postpartum Hemor- 
rhage, from the June 21, 1952 issue €f the Journal of the American 
Medical Association, to be abstracted for the 1952 Year Book. He 
has also asked thät we reproduce Figures 1 and 2 which appeared with 
the article. 

Will you please send us the original drawings of these lllustrations, 
or glossy prlnts thereof ? We shall be glad to retum them as soon 
as the book Is published, and, of course, we shall give füll credit 
to both you and the Journal. 

The manuscript for this Year Book will be sent to the typesetter in 
the near future and we are now makiing the engravings for the book. 
Will you, therefore, please send us the drawings or photographs by 
retum mall, or let us know when we may expect to receive them? 



Sincerely yours, 

THE YEAR BOOK PUBLISHERS, Inc. 



FW/bba 



^. 



"^/l-#-<^€.^-C^ 



(^ xxJUaJ^^oJiJI 



Frances Wetherhold v 
Managing Editor (Year Books) 



~:«H!«4;:'3Ki«%«^<« >Wä«Maüa^yHI 



MUk-' 



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EDITOR 
AUSTIN SMITH. 



M.O. 



ASSOCIATE EDITORS 

Johnson F. Hammono, M.D. 

GEORGE HAL.PERIN, M.O. 



J51|0 Journal of tl\t 
Amf rtran Meixtul Aßanriatinn 

535 Norttf Bfarborn »trrrt 
(Stfiradii 10 



ARTICI.es ,\RE ACCEPTED FOR I'UBI.ICA- 
TION ON COMirnON THAT TIIKY AkF. 
(ONTKll'.l'TKl) SOI. Kl. Y TO TM IS JOIKNAL. 



In your reply pleaie | 
refer to these inltlali i 



A5:gc 



November 9, 1951 



Dr. Erneet Myller 
65 Bast 76th Street 
New York 21, N. Y. 

Dear Doctor Myiler: 

Your paper entitled "Control of Postparttun Hemorrha^e" ha« 
"been accepted as a clinical note for publication In The Journal 
of the American Medical Association, suhject to slight editorial 
modification and subject to a delay in piablication due to a 
large hacklog in Communications. The paper is also accepted wlth 
the tinderstanding that it is contributed solely to this Journal. 

A proof will be sent to you before publication. 

Very truly yours. 



JOÜRHAL AMERICAN MEDICAL ASSOCIATION 



i 



.«j«i8i«!iM»«a>> i- «W i m, ««» 



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CITY OF HEW YOHK 
STATE OF HSr TOM 

coüHTi of net: 10» 



SS 



On thi» day personally app0?:red before M 

HAUS D. FROEHLICH 
restdlng et 111 - 10, 76th Read, Forest Hills, N.Y«, who after 
belnf: dtily swom, deposes and 8ay»| 

Th»t he Is thoroughly ft-imllifc^r wlth the ^glish and 
Greek langw^gesf 

Thftt he personally nade the at'acbed translation amA 
hereby certlfies to tbe best of bis knowledge and bellt^f that 
It Is fi true Tersion of the original docuaent written in the 
Greek language» 



^a,.^*^ y. /fe^^^^^ 



Svom to before ae the *otary Fublie 
on this 13th day of ^oremhmr 1941 





r 



URrvf'HSiTi or a 



DIRflCTOR OF MEDICAL rCIDOL 



Ati^iand^ May 15, 19t5 



File No S49A071 



CHR'^IFTCATS 



Dr« HN^T J. I^ELLFil, doctor of aeaiclne, iTTAdUf.ted fr«i 
the Uttiversity of Berlin^ bom at SofaMalkaldaiiy Gernany 

PASSED KITH HORORS 
2^ cxrjalnation bcld in accordance with the laws of thlf 
^nirersity aa of '^pril 15, 1956 imd is hcreby j^r^ntod & 

LICfUSE TO FR/CTICE WlDICIlfl 



in Gr«^ce And hold gorei 



it poaitions« 



Sgdl (illegible) Dircctor 
■ ■ 8«cr«tAry 



S • a 1 



1 

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CITY OF NEW YORK ) 
STATE OF NEW YORK ) 
COUNTY OF NEW YORK) 



SS: 



On this day personally appeared before me 

who, after being duly sworn, deposes and says: 

That she (he) is a professional translator 



of the English, OiiWMI^ «••• 



languages, 



employed by the National Refugee Service, Inc., 165 West A6 Street, 



New York, N.Y.; 



That she (he) has personally made the 



attached translation(s) and hereby certifies to the best of her 
(his) knowledge and belief that it is (they are) a true version(s) 
of the original document(s) written in the 



language(s) • 



ma/l \ U 



Ä 




\ 



Swom to before me, the Notary Public 
on thi§/l^ day of Mtf wismc , 19^1 





KOTAllT PÜBUC. W..tcb^t- CO. 
r,^ r. (M\;'8No.975Reg.^o.3L597 



Ji.Y.Co.ClV'sN- 



Term 



-^78a-7/a 



iatüm 



r 



JSäSL 



i.^52«ioe 



19I):^A9 



^ AT SCIB-.LK 



li-TURITY CF-:?iriCATg 



Ernst Müller 
tom Fcbrunry 1^6, 1893 nt 3cbanlkald«a> Dia tri et estiite ScbiMilkald«! 
of Jöwish f^iith, eKm of tho drugri^t Joseph liuell«r of ^hsalkald«» 
ti%tiSd«d 9 jtk^r^ tb& Obf^rrealsotaule^ 2 tharr^of ths hi^^JH^t gr dm {?riw) 



l ,C9R^*\^g^ ^,n<^ PU^^^®» 



1) Oaciductt food 

2) Dollgencei very pood 



Ba «M «SBtiqpt froiB tb" oral nxtmini^tion 



1) RaLigioo (lo Je^sh reIlgi<}o 1 Mons arr> giip«i ut the school) 

2) OersHttit f^ir 
5) Fr^^chi good 
4} EhgUahl gCKxi 
5) HlfJtoryt fooA 
•) Qeogrt pl^jyi fair 
7) & tliM&tlosi good 
•) Fbersioat fOOd 

9) Cheal^tryi coo4 

10) Patxiral historyi'— 

11) Othba tlott fair 

12} fraalMd dr .ringt fOod 
13) Unmor draMngt 
14} Singingt ~— 
IS) Ifeadknitia«* tmiw 



n 



« 2 « 



TlM imderslgned Board of Bx^mlnera theroforo gr nts Ma m 
MATOHITY CEnriflCATE 
•ince hß is leavlnf )±3 Oberreulsch Xa to study ■•dicltt« and diamisse j 
tdm with the bo^t wisbea for his futurc* 



SchiÄlkrlden, M^rcb 25^ 1911 



Boyal Provincial 
School Board« Cassol 



Royjil Bo-ird of fxaaliier» 
Si^iature^ of ex'minmrs Md ter^chers 



Um att«id«d the optional Lntin lesson« teld in 



eoocectlon «Ith tho three higbeat 



of th^: Ob raalacbula 



with satisfectory rc'sul^^a« 



SobMÜUwldMi» Marob 22, 1911 



Blr^etor of the ^^rrorlschule 



Vha fthw» ffipiiiture is eartifiad oorrect 

Barlin "ov^ftber iX), 1953 

agd« BrcmadM Ol&Tk of the ^ourt 

"^ abov9 Signa tiire is eirtlfiad oorreot 

Berlia^ ^armber 20> 1953 

s^d» Block OouDty Court ?r sidaat 

The abovo 8l|^t«r« ia oertified corract 
Barlia, Boir««bw 21, 19if 
•gd« Ballte ForaigD ^ffloa 

Seala 



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WÜERZBÜRG 



LEAVIÄG CERTIFICATE 



ITI 



ERlfST MUrLLER of Sobaialkaldoii, bon at ScbKlkalden 
tHi» enrolled froa April 29^ 1911 to dntm^ h& a Student of 

mediclno 
at thiB ^iv rsltjf and reglnt red diAr to tho lacturüf? deai^aV-d 
kttTttlD'^fter« 

C«3Cöming kils cc«iduct nothln^: derog<3tory haa böoa rfjported durlag 
thiß period» 

IH t;IT«ESS WIERJO? this certlflc te hasJ betwi isoued and the 
««fil of the Univt^r^lty and the pisraottel signeture of the actlng rector 
1^ the önlvcralty «yndlc affix»d th^reto» 



7.burSf April 11, 1911 

üniv raltQT ^ctopt Bg}i. Prof« Dr# K»B» Lel^aann 
^alvoraity Syndlot srdm illerible 



Sefil 
» 17882 



HQ^mf 



1911 



Unter xm2/in2 



Oat^ology 
Orgnalc ofae»l3tr]r 

Botiioy 

Jnatoay I 

Dl^^sectloo laboratoT7, courii« X 



iMTsburg^ April U, 1912 



3mX 



B« Onire jity Sindyc 
s^m illaglbl« 



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w c 



RECTOR AHD SEH ATI 



OF -^W HOTAL CIIFJSTäH äLBEFCIIT ÜWIWrr.ITr AT Ktt 



MfUtf ko^ tids loarlng certificate that llr, EHH^T M U E L L E 1 

born at Scimalkalden 8on of tb^ drugglst «X« Iflller, prepared for 

«Cfedewic Studios at the Oberreal schule at Schnalkp.ldfln^ 

ime Bstrlciilfited wlth us on th^: strength of a Icaving certificate 

frcan the üniveraity l^vTEburg, on %i'll ^, 1012 and de-fot^d hi»»elf 

to th*^ otuciy of a e d i c 1 n e« 

^rinf: bis 8 aontha stay t thln UntT^-rsity, b duly regiaterad to 

the lectures h-^rr-in ^f tor spocifiod, Gn<l in ccord^nce ^Ith certiflc tea 



•ubaittedy aal gave notice# 



.affiäJl 



i.^!SLl.^k 



Systa»:tlc anf.tomy of the fauar.n body II 

a) Mcxvous 3y: ten 
^rr^ctlcal coxirse in chtjiistry for 

•edicul students 
Short surv^y on inorgaaic and organlc ch«Äistry 
Physiolory of thß »uaclea 

Oa»cemini: hl« ccaiduct at trie ünlversity nothinp derogatory ha. 
reported« 

Iss\a0d by tte aoting Rr.ctor^ Signature aad seol affix«d« 
*lol, iugUi3t 2^^ 1912 



09(M 



Seril 



9(^ ille|ible 



S(*d» Werner 
%iv*:rslty Secr<?tary 



Bmm on 
Mit^xst Ip 1912 






n 



Mo 945 



TOTAL BAVaRIAK JULIUS M/^XIMILIAR ÜNIV ^::iTI immZBÖHO 



L^iVniG CTa^mnCATt 



Vr» Imst II € 1 1 e r of Scbaalkaldeiif bom at Sch»<ilkald«i 
«Ätridilated at t'rds ^Iversity fro« ^ctobtir lö, 191* to dfite 



as e Student of 



e d i c i n 



and duly ref^ist^red to tlr» lectures br*r(3lnftfter speclfi^d» 
Conc?mlng bis conrKirit durin thi3 p riod oothia^! d ror tory < ^3 b«4 



peported^ 



IN riTR'^S^* irmOF thlö certiflcf.t« te« 



iatwd and tbe 



• ftl of thß **nivF?rslty axtd thc; personal sif?:n«ture.^ of the actlng ri*ctor 
and the univ(?r«lty aiyndic nfflxed therrto# 



Hueraburp:! AurtiEst 13, 1913 



Seal 



üniv r-Jlty Rector 
ngd« Prof« Dr. ^. Hei» 



üniversity ^yndic 
Hgdm liucller 



S«aie3te(r 



DeBlgnatioo of Lecture 



flntcr 1912A»» 



1915 



MaMctlon exerciaea ^d oourse 

FbQraiaOLogy 
Zooloj^ 

Topographie i^atosf 
Bapetition cotirsa in anntoay 
Fby3iolofic chfiÄistry 



Phorsiolofgr 
^opogrepidc an^toagr 
Ixerciaaa in p^^iolo 
^^loty 

in »icroscopy 






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1 



CEHTIFIC/TE 
by thi 
Botxrö of ^*aiii*.tr» at Ihieraburg 

* 

on the 
»«Kilcal prelljilnary ©x'^min tlan of th* 
Student of »edicine Mr# " PJIfrr MOFLLIl of ^ctaMÜLkAld« 

IHHH»«^»HNHHHi> 



Th- follofwinp m rkn wem giv»?n »vUi ßft*3r tha 
prellalnary ex-^idBatlon htdd in accor<i«nce with the i*xr*ialn blon 
or(5cr of Ity 28, 1901« 

1} In anfttooy 

ii) In Physlology 

5) In Pborrsics 

4) In Cb^alstry 

5) In Zoology 
t) In Botany 

thu@ the avBrage rating 

» TRI GOOD * 

lUersburpi JTuly 17, 1915 

^1* ohalmeii of tho bo rd of exa«in&rs 



he 


a&rk 


very good 






Vf?ry px>o<l 






T ry f:ood 






good 






▼«ry cx>od 






good 



tigd* %derlflfi 
Seal 



Lee'.llait^d 
VsersbuTf , Mowmävr 20, 1955 



\ 



»t of fct«'rftrft^en aiKl Aschaffenburg 

Obwiber for Intt^mal Affalrs 



Seal 



»g^i# 111^ 'fl 



j 



r 



1025/482 



ÜNIVFRSITT 



ü K I C H 



ÄRTIFTCATE 
WHöl LK/VIHG THE ÜNIVKRSITI 



Mr. Ernst 1 Ä 1 1 e r, of Schnalknlden^ bom -t Sctanalkadc» 

was matrtculat©d at tlds lÄalTerslty froa October 28, 1915 tvirourh the 

end of the suauaer »«laster 1917 as t^tudent of nedlcine 

and rec;lstered to the lectures desit-nated In tl» at^^^ched coller:^» book» 

Concemtng hls conducts during this period nothing derogatory 
has b#en reported» 

IN fflTHESS WHERBOy this certificate ht s l>e«i isBued and the 
university seal^ as well as the personal si^riatureM of the actinr rector 
and syndic of the uniwersity affixed thereto» 



/ 



Munich, Deceaber 5, 1917 

The acting Rector 
sgd, 0* ^eigl 



StAl 



The ^dic 
8^d« Dr« linh&user 



Propaedeutic gynecologic clinic 

Thftrapeutics of internal diseases 

Pain preventlon in surgery and practicel 
•zorcieee 

Surgical propaedftutiis (aiirgical diagnoiia 
and sur^cal therapeutic», exerciaef) 

ItMÜcnl clinic for beginners 

M^^tal diaeaaaa 

dlnio and polyclinic of pediatz*ic diseaaea 
indudinf^ phyaiology and pathologj 
ef na'^rition in infanta* aga 



4 
X 



i 
t 



n 



•urgloal clinlc 

Obstetrtc pynecologic clinic with clinlcal and 
polydini al obstetrlc observ^tions and 
exercises in touch e»i»inrationa 

Otlatric clinlc (with otoicopy) 

Ixercise» in dißgnoaifl on polyclinicol patient« 

Rhino - laryngolof:ic clinic 

ThÄoretic and pr-:tctic/.a racclncition cours« 

Clinic for Syphilis and dematolordc diseAsa« 

■edical clinic for advrmced t^tudanta 

Intubatic»! and tr.xcheotoay 



Winter se«ester 1914/1915 
Sianer Semester 1915 
hinter seaisster 1916/1916 
Siawer aeaester 1916 
Winter ae«ester 1916/1917 
*^iairaer »eraester 1917 



Fage 2 
^m-H r>fi r wi 



6 

t 

1 
2 

1 
2 
6 

1 



Isare of abaonc«! i» the aroy« 



seala 



\ 



r 



n 



IE R7CT0H iND SERATI 

0f WR »TAL mmnm wiLmw mny^nsin at beblik 



ctrtlfy W thia le^ivlnp' certlficßto thot Ir. imtST 1 ü E L L I R 
bom at Sohi&Lkaldfifi in RetfMB-JlasMiiy ton of the Mrohuit MUer 
«a« preparod for acadeeic £^tudi69 at the Ob^rrealschul« at dalaaXkfldea 
and waa w^tilculated wlth u» ob the strcn^h of a 1©^ ving certtficata 
froa the öiiiverslty Munich on ^or «her Z2, 1117 ßad rcna^inad hara 



as a sttident of 



»adlclna 



until the and of the sumer seedster I918» 

Durlng the tlae he nttendad this yniversity he duly raglsterod to 
thö Iftoturea «pecified in t^ie att&ched liw^tt 



l 

t 

I 



fepariJMBtal pharsaoelog/ 
Forcaisic aadicina 
TopograpMc anat<Mgr 

II Syer SeaePter 193^ 

iadic^il poXydinle 
Obatetidc igmacologic clinic 
Piychiatrio clinic 
dftrgioal clinic 
Ophtbidaie diaic 

Couraa in patholofic anatomy and ext^rctaaa 
Couraa in »icroacopy In p/tthoIo|ic faistdlogy 
in pathology on fresh praparr.tiana 






r 



n 



Fft« staap 



After the candidate of »«dicixitt 
IfMST MUELLER of Scbnalkaldon has passed hls 
nedioal examinatlon before the board of ezaainers at 
Berlin with the aark • g o o d • and hls war serYlcef 
hflid been t&ken account of in sterd of the obllratory 
pr»ctical interne yertTp ha is hereby granted • 

UCmSS AS FBISICIAll 
valid froa the Äoveaber 27, 1918 and for the territory 
of the Geraan Raich In .iccordanoa with Par 29 of the Reichs 



ordar« 



Barlln, Daceaber 17^ 1916 



Seal 

Mlnlstry of Interior 

By Order 
agd# lircfaner 

Seen for Terificetiwa of 
abore aign^tura 
Bariin, »oveabar 7, 1955 



Saal 



The Foreign Office of 
t\m ^eraan Reich 
agd« Reiaka 



L I C E H S E 
for 
Imet ■ fl 1 1 e r 
aa pligriician 



r 



n 






\ 



\:iii THir. jxüix To kappin e.'^g 

IN TKi. rmiiDHlCH-WI'.ULliftS 

ü';ivi:-.:'iTy m b, i^iii 

üfKicr the »ftgnificont EectoraLiTi of Roinold v^'e'3b9rg, Doctor of 

Thoo ogyp Doctor h»c. of Luw and Philo-jophy, Public ?r"»res3or 

In orülnary nt thia Unlv^a-sity, ♦ 

by Order of th*^j ßraciouii Tj^culty of Medien«, 

Wilhelm Kia, duly comaip.'^on^'d Pr motori Doctor of i'^^iclne ^nd 
Surgery, Public Professor in Orcim;ry t;t ^hia Univsrsity, • 

Dei.n ^ro tsa. o* thc Fuculty of MrJicine, 

ha« löwfully conforrod u^on the eio^t la^.med 

Km3t li u a 1 1 a r 

of hes?en-^^e.3niiu, 

a raetUcal pr^ictitioner, 

tlie prero^atlves und Privileges, tbo de^xeo and tho honors of 

DOCTOr. OF l!KDICINi: 

lifter he pes.-^ed the ortl exufcüntition and / :'t«r hie praia^ivorthy 
th<98i8| »ritten In th^ Gerausn lunfutfe ' n leiiring the tiüe* 
•UJeber die Tor»ion des Saa^nstrenga* y^&s pr ntof* with tlm sporoval 
of th« Fsculty« 

This i7th «lay of J^nuary 1919t 

m f ITNEf^ W? K;trX)F TIII-^ V^L^J^ \h\r BEt:N IF^^UED üfIDEi; THii ?EAL 
OT^ Tfil FACULTT. 



/ 



Th'^' £enuinen«S8 of th# (0^&l) 

oi^n tur« o^ the Hector 

of thÄ l'niv^^raity o'' **er~.in 

ia hireby certifiod, 

Berlin, J^oveubei' 9, 1923. 

The Prusaifoi ^^inister of ßcienc«, 
Art and Public Educationt 
Byt 8g • Or. Amk«l. 

( 8<i8l) 

»8719 



8^c, HiSf -*«ftn pro toa, 
The ''or^jgoing aiiü. tui*e hes b'^en ftffixed 
by th« Dettn of the l&culty of ^'«tiicin« 
fet th>tt tim«^ Prcfeflsor D-* Hls» 
Berlin, Koveaber 6, 1833 • the Etctort 
(s^ül of the Unlveraity) sgd.illegible 



8aen for certificution of th« feforog ng 

sirnüture« 

Bariin, Uoveiibor 16, 19S5» The Foralfn Offica 

of the Cleim&n Reicht 
Byt s^-d, ille^flble. (ge&l) 

♦ Tr&nsltitor*ö notat further titla» 0E;itted» 



MEMBERSHIP DIRECTORY 
for 1954 




THE AMERICAN SOCIETY 

for the 



STUDY OF STERILITY 



OFFICERS AND DIRECTORS 

1953-1954 

B. BERNARD WEINSTEIN 
President 

ROBERT HOTCHKISS 
Vice-President 

HERBERT H. THOMAS 
Secretary 

CARL E. JOHNSON 
TreaBurer 



BOARD OF DIRECTORS 

S. Leon Israel 1954 

Myron G. Fincher _ 1954 

Somers H. Sturgis — 1956 

J. P. Greenhill - 1955 

Willis E. Brown _ 1966 

Pendieton Tonripkins 1966 

FAST PRESIDENTS 

Walter W. Williams 1944-1947 

Lyman W. Mason 1948-1949 

Lewis Michelson „.1950-1951 

Fred A. Simmons 1951-1952 

Irvin F. Stein _ 1952-1953 



ROSTER OF MEMBERS 



HONORART MEMBERS 

HAMBLEN, EDWIN C, M.D. 

Endocrine Division, Duke Hospital, Durham. N. C. 
HARTMAN, CARL G.. M.D. 

Ortho Research Foundation, Raritan, N. J. 

LANE-ROBERTS. CEDRIC S., M.D. 

The Mill House, Tewin, Harts. England 

PAPANICOLAOU, GEORGE N., M.D. 
1300 York Ave., New York. N. Y. 

RUBIN, ISIDOR, C. M.D. 

911 Park Ave., New York, N. Y. 

8TONE, ABRAHAM. M.D. 

40 Park Ave., New York 16, N. Y. 



FELLOWS 

BROWN, WILLIS E., M.D. 

University of Arkansas, Little Rock, Ark. 

CHARNY, CHARLES W., M.D. 

2039 DeLancey PL, Philadelphia 8. Pa. 

DABNEY, MARYE Y., M.D. 

2300 Highland Ave., Birmingham. Ala. 
DAVIS, M. EDWARD, M.D. 

5841 Maryland Ave., Chicago 37, III. 
DOUGLAS, GILBERT F., M.D. 

1923 So. 14th Ave., Birmingham, Ala. 

GLASS, SAMUEL JR.. M.D. 

860 No. Bedford Dr., Beverly Hills, Calif. 
GREENHILL, J. P., M.D. 

65 E. Washington Blvd., Chicago. 111. 
GUERRERO. CARLOS D., M.D. 

Miguel Schulz 19, Mexico City, Mexico 
GUTTMACHER, ALAN F., M.D. 

Mt. Sinai Hospital, New York City, N. Y. 

HAMAN, JOHN O., M.D. 

490 Post St.. San Francisco 2, Calif. 
HOTCHKISS. ROBERT S., M.D. 

66 E. 66th St.. New York 21. N. Y. 



ISRAEL, S. LEON. M.D. 

2116 Spruce St., Philadelphia 3, Pa. 

MacLEOD, JOHN, Ph.D. 

CorneU Univ. Medical College, 1300 York Ave., 

New York. N. Y. 
MASON, LYMAN W., M. D. 

1214 Republic Bldg., Denver, Colo. 
MAZER, CHARLES. M.D. 

2047 Spruce St., Philadelphia 3. Pa. 
McLANE, CHARLES M., M.D. 

960 Park Ave.. New York 28. N. Y. 
MEIGS. JOE V., M.D. 

Vincent Memorial Hospital, Boston, Mas». 
MICHELSON, LEWIS. M.D. 

490 Post St., San Francisco 2, Calif. 

POMMERENKE, W. T.. M.D. 

Univ. of Rochester Medical Center, Rochester, 
N. Y. 

RAKOFF, ABRAHAM E.. M.D. 

269 So. 19th St.. Philadelphia 3. Pa. 
ROBERSTON. EDWIN M., F.R.C.O.G. 

Kingston General Hospital, Kingston, Ontario, 

Canada 
ROCK, JOHN, M.D. 

32 Cumberland Ave., Brookline, Mass. 

SALMON. UDALL J., M.D. 

875 Fifth Ave., New York 21, N. Y. 
SIMMONS. FRED A.. M.D. 

330 Dartmouth St., Boston, Mass. 
STEIN, IRVING F.. M.D. 

80 N. Michigan Ave., Chicago 2, 111. 
STURGIS. SOMERS H., M.D. 

721 Huntington Ave., Boston, Mass. 

TOMPKINS, PENDLETON, M.D. 

450 Sutter St., San Francisco, Calif. 

WEINSTEIN, B. B., M.D. 

1421 Delachaise St., New Orleans 15, La. 
WEISMAN, ABNER I., M.D. 

1160 Fifth Ave., New York 29, N. Y. 
WILLIAMS, WALTER W., M.D. 

20 Magrnolia Terrace. Springfield, Mass. 



ACTIVE 



ALVAREZ-BRAVO, ALFONSO, M.D. 

Plaza de la Republica 7, 40 Piso, Mexico 1, D. F. 

BELDING. DAVID L.. M.D. 

215 Main St., Hingham, Mass. 



BICKERS. WILLIAM, M.D. 

412 Med. Arts Bldg., Richmond. Va. 
BIRNBERG. CHARLES H., M.D. 

191 Ocean Ave., Brooklyn, New York 
BLANDAU, RICHARD J.. M.D. 

6531 37th St., N.E., Seattle. Wash. 
BRODNY, M. LEOPOLD. M.D. 

636 Beacon St., Boston 16, Mass. 
BURKE, JOHN E.. M.D. 

86 Lincoln St., Framingham, Mass. 
BUXTON, CHARLES L.. M.D. 

Yale University Medical School, New Haven, Conn. 

CARTER, BAYARD. M.D. 

Duke University Hospital, Durham, N. C. 
CASTRO, EDUARDO, M.D. 

Uruguay 90, Mexico 2, D. F., Mexico 
COHEN, MELVIN R., M.D. 

80 No. Michigan Ave.. Chicago, 111. 
CROSSEN. ROBERT J.. M.D. 

901 University Club Bldg.. 607 N. Grand Ave., 

St. Louis. Mo. 

DECKER. ALBERT. M.D. 

10 W. 74th St.. New York. N. Y. 
DODGE. EVA F., M.D. 

University of Arkansas. 2124 W. llth St.. Little 

Rock, Ark. 
DOYLE. JOSEPH B.. M.D. 

66 Bay State Rd., Boston, Mass. 

FARRIS, EDMOND J.. Ph.D. 

The Wistar Institute. 36th and Woodland Ave.. 

Philadelphia, Pa. 
FINCHER, MYRON G.. D.V.M. 

New York State Veterinary College, Cornell Uni- 
versity, Ithaca, N. Y. 
FINKLER, RITA S.. M.D. 

86 Leslie St.. Newark 8. N. J. 
FISTER. GEORGE M., M.D. 

886 24th St.. Ogden. Utah 
FOLSOME, CLAIR E.. M.D. 

1249 Fifth Ave., New York 29, N. Y. 
FRIED, PAUL H., M.D. 

1812 Spruce St.. Philadelphia 3, Pa. 
FREIDMAN, LOUIS L., M.D. 

817 Lowry Medical Arts Bldg., St. Paul 2. Mlnn. 

GALLO. DELFINO, M.D. 

Justo Sierra 888, Guadalajara, Mexico 
GETZOFF, PAUL L., M.D. 

400 Medical Arts Bldg.. New Orleans 16. La. 
GOLDZIEHER, JOSEPH. M.D. 

1188 Medical Arts Bldg.. San Antonio, Texas 



GRAY, LAMAN A.. M.D. 

408 Heybum Bld»., Louisville 2, Ky. 
GREENBLATT, R. B.. M.D. 

Medical ColleRe of Georgia, Augusta, Ga. 

HARTNETT, LEO J.. M.D. 

422 Missouri Theatre Bldfir., St. Louis 3, Mo. 
HELLER, CARL G.. M.D. 

Univ. of Oretron Medical School. Portland. Ore. 
HELLMAN. LOUIS M.. M.D. 

Helen Street, Greenvale, L. L, N. Y. 
HOWARD, R. PALMER 

Oklahoma Med. Research Inst. & Hospital 

825 N.E. 13th Street. Oklahoma City, Okla. 
HUDGINS. ARCHIBALD P., M.D. 

403 Professional Bldg., Charleston. W. Va. 
HUGHES, EDWARD C. M.D. 

713 E. Genessee Street, Syracuse, N. Y. 

INGERSOLL, FRANCIS M., M.D. 
264 Beacon St., Boston. Maas. 

JOHNSON, CARL E., M.D. 

364 Oak Street. New Haven 11, Conn. 
JONES, G. E. SEGAR. M.D. 

110-111 Medical Arts Bldg., Baltimore, Md. 

KANTOR. HERMAN L. M.D. 

3534 Maple Ave., Dallas, Texas 
KLEEGMAN, SOPHIA J., M.D. 

59 E. 54th Street. New York, N. Y. 
KURZROK, RAPHAEL, M.D. 

1016 Fifth Ave., New York, N. Y. 

MACK, HAROLD C. M.D. 

3001 W. Grand BIvd.. Detroit, Mich. 
MARBACH. A. HERBERT, M.D. 

Suite 1201, Medical Tower, Philadelphia 3, Pa. 
MASTERS, WILLIAM H., M.D. 

630 S. Kings Highway. St. Louis, Mo. 
MULLIGAN, WILLIAM J.. M.D. 

32 Cumberland Ave., B»-ookline 46, Mass. 

NELSON. WARREN O., Ph.D. 

State Univ. of Iowa, College of Medicine, Iowa 
City, la. 

PAGE, ERNEST, M.D. 

3031 Telegraph Ave., Berkeley, Calif. 
PALMER, ALLAN, M.D. 

2107 Van Ness Ave., San Francisco, Calif. 
PAYNE, SHELDON, M.D. 

921 Westwood Blvd., Los Angeles, Calif. 
PERLOFF, WM. H., M.D. 

1930 Chestnut St., Philadelphia, Pa. 



POLLAK, OTAKER J., M.D. 
P.O. Box 228, Dover, Del. 

REIFENSTEIN, EDWARD C, JR., M.D. 

27 Hawthorne Ave., Bloomfield, N. J. 
ROMMER. J. JAY, M.D. 

26 Ingraham Place, Newark, N. J. 
ROTH. ARTHUR A., M.D. 

1021 Prospect Ave., Cleveland, O. 
RUBENSTEIN, BORIS B., M.D. 

185 N. Wabash Ave., Chicago. 111. 
RUTHERFORD, ROBERT N., M.D. 

707 Broadway, Seattle, Wash. 

SHIELDS. FRANCES E., M.D. 

New Haven Professional Bldg., 462 Jefferson St.. 

Monterey, Calif. 
SHUTE. EVAN V., M.D. 

10 Grand Ave., London, Ontario. Canada 
SILBERNAGEL, WYNNE M., M.D. 

9 Buttles Ave., Columbus 12, O. 
SINGLETON, J. MILTON, M.D. 

315 Nichols Rd., Kansas City, Mo. 
STUERMER, VIRGINIA M., M.D. 

2900 Vine St., Lincoln 3, Neb. 

THOMAS, HERBERT H., M.D. 

920 So. 19th St., Birmingham, Ala. 
THOMPSON, WILLARD O., M.D. 

700 N. Michigan Ave., Chicago 11, 111. 
TURNER, VIOLET H.. M.D. 

Duke Hospital, Durham, N. C. 
TYLER, EDWARD T., M.D. 

10911 Weybum Ave., Los Angeles 24, Calif. 

VOLLMER, ALBERT M., M.D. 

384 Post St., San Francisco, Calif. 

WEED, JOHN C, M.D. 

Ochsner Clinic, Prytania and Aline St»., New 

Orleans 15, La. 
WEIR, DAVID R., M.D. 

2102 Abington Rd., Cleveland 6, Ohio 
WEIR, WILLIAM C, M.D. 

10515 Carnegie Ave.. Cleveland. Ohio 
WHITELAW, M. JAMES, M.D. 

655 Sutter St., San Francisco, Calif. 



ASSOCIATE MEMBERS 

ABRAMSON, DANIEL, M.D. 

127 Bay State Rd., Boston, Mass. 

ALBERT, A., M.D. 
102-110 Second Ave. 



S.W., Rochester, Minn. 
9 



ALBERT. LOUIS. M.D. 

476 Commonwealth Ave.. Boston. Mass. 
ANDERSON. HARLEY. M.D. 

1107 Medical Arts Bldg.. Omaha. Neb. 
ANDROS. GEORGE J.. M.D. 

420 W. Ottawa St., LansinR. Mich. 
ANGELUCCI. HELEN M.. M.D. 

136 S. 16th St., Philadelphia, Pa. 
ARNHEIM, FLAK K., M.D. 

8612 Fifth Ave., Pittsburgh 13, Pa. 
ARZAC, J. P.. M.D. 

Monte Libano 340. Mexico City. Mexico 
AUGUST. RALPH V.. M.D. 

72 Broadway. Muskegon Heights. Mich. 
AUSLANDER. HAROLD P., M.D. 

2840 Coral Way, Miami Beach. Fla. 

BANKS. A. LAWRENCE, M.D. 

707 Broadway, Seattle 22. Wash. 
BARKER, C.A.V., D.V.M.. M.Sc. D.V.Sc. 

Dept. of Medicine and Sur^ery 

Ontario Veterinary Collesre, Guelph. Ont., Canada 
BELT, ELMER. M.D. 

1893 Wilshire Blvd.. Los Angeles. Calif. 
BEHRMAN. SAMUEL J.. M.D. 

617 E. Liberty St., Ann Arbor, Mich. 
BENESOHN. SOL, M.D. 

66 E. Washington, Chicago, III. 
BENJAMIN. JOHN. M.D. 

Strong Memorial Hosp.. Rochester. N. Y. 
BENNETT, ALWNE E., M.D. 

808 Republic Bldg., Cleveland 16. Ohio 
BERLIN. ALLEN. M.D. 

722 Macabees Bldg.. Detroit 2, Mich. 
BERMAN. ROBERT. M.D. 

299 Clinton Ave.. Newark. N. J. 
BISKIND. GERSON R., M.D. 

460 Sutter St., No. 1489, San Francisco 8. Calif. 
BISKIND. MORTON S.. M.D. 

Westport. Conn. 
BLACK. WILLIAM T.. M.D. 

899 Madison Ave.. Memphis. Tenn. 
BRAND. ELLIOTT. M.D. 

146 Sherman Ave., New Haven. Conn. 
BRANNON. ROBERT M., M.D. 

2121 Highland Ave., Birmingham, Ala. 
BRANSCOMB. LOUISE. M.D. 

1026 Woodward Bldg., Birmingham, Ala. 
BROWN. HUNTER M.. M.D. 

1922 lOth Ave., S., Birmingham. Ala. 
BUERGER, CLAUDE L., JR., M.D. 

1466 Springhill Ave.. Mobile 17, AU. 
BYRON, CHARLES, M.D. 

346 Schermerhorn St., Brooklyn, N. Y. 

10 



CANNIS, JOHN P.. M.D. 

926 Park Ave.. Plainfield, N.J. 
CANTOR, EDWARD B.. M.D. 

4849 Van Nuys Blvd.. Sherman Oaks. Calif. 
CARLSON. HJALMAR. M.D. 

1816 Professional Bldg.. Kansas City, Mo. 
CARRABBA, SALVATORE, M.D. 

179 Allyn St., Hartford, Conn. 
CASTALLO, MARIO A., M.D. 

1621 Spruce St.. Philadelphia. Pa. 
CHAPPELL, AMEY, M.D. 

79.5 Peachtree St., N.E., Atlanta. Ga. 
CHIDESTER, AUGUSTUS B., M.D. 

120 Genesee St., Auburn, N. Y. 
CHRISMAN, R. B., JR.. M.D. 

701 du Pont Bldg., Miami, Fla. 
CINER. LEONARD F., M.D. 

68 East 79th, New York, N. Y. 
CLINE, WADE, M.D. 

2018 15th Ave.. S.. Birmingham, Ala. 
COCHRANE, CLELAND, M.D. 

701 N. Peninsula Dr., Daytona Beach. Fla. 
CORCORAN, MICHAEL A., M.D. 

689 Asylum Ave., Hartford, Conn. 
CORTESE, THOMAS A., M.D. 

4.35 South East St. Indianapolis, Ind. 
COULTON, DONALD, M.D. 

326 State St., Bangor, Me. 
CRAWLEY, LAWRENCE Q.. M.D. 

101 East 89th St.. New York 28, N. Y. 
CRISTOL, DAVID S., M.D. 

255 S. 17th St.. Philadelphia 3, Pa. 
CRUTCHER, H. K., M.D. 

1511 N. Beckley, Dallas, Tex. 

DANFORTH, DAVID, M.D. 

636 Church St., Evanston, 111. 
DANIELS. ANNA KLEEGMAN, M.D. 

322 W. 72nd St.. New York 23, N. Y. 
DAVIS, JULIUS T., M.D. 

4414 Magnolia St., New Orleans, La. 
DE CARLE. DONALD W., M.D. 

2000 Van Ness, San Francisco, Calif. 
DICKERSON. DONALD L.. M.D. 

107 N. Franklin St., Danville, III. 
DIETER, DONALD D., M.D. 

416 So. Santa Fe, Salina, Kans. 
DIPPEL, LOUIS A., M.D. 

309 Hermann Professional Bldg., Houston 5, Tex. 
DOBSON, CATHERINE L., M.D. 

25 E. Washington St., Chicago 2, 111. 
DODEK, SAMUEL M., M.D. 

1730 Eye St., Washington, D. C. 
DOUGLAS, JOSEPH W., M.D. 

1900 North Palafox St., Pensacola. Fla. 



11 



EFSTATION. THOMAS D.. M.D. 

84 W. Market St., Tiffin, Ohio 
EMMONS, CARL W., M.D. 

Women'8 Clinic, 2495 Center St., Salem, Ore. 
ENGLE, EARL T., Ph.D. 

630 W. 168th St.. New York, N. Y. 
EPPERSON, JOHN W. W., M.D. 

West Grand Blvd. and Hamilton Ave.. Detroit, 

Mich. 
ESSIN, EMMETT, JR., M.D. 

109 N. Walnut, Sherman, Tex. 

FELDMAN, HAROLD, M.D. 

131 Linwood, Buffalo, N. Y. 
FINEGOLD, W. J., M.D. 

3500 Fifth Ave., Pittsburgh 13. Pa. 
FIRST, ARTHUR. M.D. 

1714 Spruce St., Philadelphia. Pa. 
FISCHER, IRVING C. M.D. 

15 E. 7l8t St.. New York. N, Y. 
FLUHMAN, C. FREDERIC, M.D. 

656 Sutter St., San Francisco. Calif. 
FOGEL, JULIUS, M.D. 

1723 M. St.. N.W.. WashinKton. D. C. 
FOND. MORRIS S.. M.D. 

1272 Grand Concourse, Bronx 66, N. Y. 
FORMAN, ISADOR, M.D. 

802 S. 19th St., Philadelphia 3, Pa. 
FORMAN, RICHARD C, M.D. 

427 Biltmore Way, Coral Gables, Fla. 
FORTIER, QUINCY E., M.D. 

2232 Seabury Ave., Minneapolis, Minn. 
FRANK, RICHARD, M.D. 

109 N. Wabash Ave., Chicagro, 111. 
FRAZIER, WILLIAM HARVEY, M.D. 

1681 Paulsen, Medical & Dental Bldg., Spokane, 

Wash. 
FREED, CHARLES R., M.D. 

1809 E. 18th Ave., Denver 6, Colo. 
FREEDMAN, HENRY, M.D. 

9 Pierre Pont St., Brooklyn, N. Y. 
FROSH, ALVIN J., M.D. 

2222 E. 18th Ave., Denver, Colo. 
FROST, INGLIS F., M.D. 

181 South St.. Morristown, N. J. 

GARRETT. SHERMAN S.. M.D. 

209 West Park. Champaifirn, 111. 
GARBER. STANLEY T.. M.D. 

104 Wm. Howard Taft Rd., Cincinnati 19, Ohio 
GARSKE, GEORGE LEO, M.D. 

322 Doctors Blds:.. 90 S. Ninth St., Minneapolis 2, 

Minn. 
GEPFERT. RANDOLPH, M.D. 

71 E. 77th St., New York, N. Y. 



1 



GERSH, ISADORE, M.D. 

242 Metropolitan Bldg., Denver, Colo. 
GODFRIED, MILTON S., M.D. 

86 Trumbull St., New Haven, Conn. 
GOLDFARB, ALVIN, M.D. 

1 East 72nd St., New York, N. Y. 
GOLDMAN, DANIEL W., M.D. 

601 Medical Arts BldR., New Orleans 16, La. 
GOLDNER. HARRY. M.D. 

1815 llth Ave., S., Birmingham, Ala. 
GONZALEZ-GUERRERO, JOSE, M.D. 

Calle Arce, Apts. Transito No. 4, 

San Salvador, El Salvador, Central America 
GOODMAN, LEON J., M.D. 

729 Pine St., Macon, Ga. 
GORBEA. RICARDO L., M.D. 

894 West End Ave.. New York. N. Y. 
GREENE, LAURENCE F., M.D. 

Mayo Clinic, Rochester, Minn. 
GREELEY, ARTHUR V., M.D. 

960 Park Ave., New York 28, N. Y. 
GUERRA, A. SALAS, M.D. 

Padremier 1043 Pte., Monterrey, Mexico 
GUERRIERO, WILLIAM F., M.D. 

3207 Turtle Creek Blvd., Dallas 4, Tex. 

HADDEN, DAVID RODNEY, M.D. 

2680 Bancoft Way, Berkeley 4, Calif. 
HAHN. GEORGE A.. M.D. 

265 S. 17th St.. Philadelphia. Pa. 
HANGE. B. M.. M.D. 

62 N. Third St.. Easton, Pa. 
HARRIS. JOSEPH M., M.D. 

183 S. Lasky Dr., Beverly Hills, Calif. 
HARSH, JOHN F., MD. 

920 S. 19th St., Birmingham, Ala. 
HECKEL, GEORGE P., M.D. 

Strons: Memorial Hospital, 260 Crittenden Blvd., 

Rochester, N. Y. 
HECKEL, NORRIS J., M.D. 

122 S. Michigan Ave., Chicago, 111. 
HENKIN, ALLEN E., M.D. 

Suite 804, Farrasrut Med. Bldg., 

900 17th St., N.W., Washington 6. D. C. 
HEPBURN. ROBERT HOUGHTON, M.D. 

85 Jefferson St., Hartford, Conn. 
HERROLD, RUSSELL D., M.D. 

6 N. Michigan, Chicago, 111. 
HINMAN, FRANK. JR.. M.D. 

Univ. of California Hospital. San Francisco, Calif. 
HODGSON, JANE E., M.D. 

611 Lowary Medical Arts Bldg., St. Paul, Minn. 
HOFFMAN. KATHRYN E., M.D. 

685 Schofield Bldg., Cleveland. Ohio 



11 



18 



HOLLANDER. ARTHUR. M.D. 

1695 Grand Concourse, New York. N. Y. 
HOWARD. FREDERICK S.. M.D. 

655 Sutter St., San Francisco. Calif. 
HOWARD. LAWRENCE L., M.D. 

1220 Central Ave., Great Falls, Mont. 
HUFFMAN. JOHN W., M.D. 

670 N. Michigan Ave.. Chicago, 111. 
HULME, HAROLD B.. M.D. 

411 First National Bank, Boise, Id. 
HUNTER, G. WILSON. M.D. 

Fargo Clinic. Fargo. N. D. 



JACOBSON. CHARLES E.. M.D. 

50 Farmington Ave.. Hartford. Conn. 
JENNINGS, ANGES F.. M.D. 

231 Grand Ave.. South San Francisco, Calif. 
JINKINS, J. L., M.D. 

906 22nd St., Galveston, Tex. 
JOHNSON. C. GORDON, M.D. 

3636 St. Charles Ave.. New Orleans. La. 
JONES, W. NICHOLSON. M.D. 

2154 Highland Ave.. Birmingham. Ala. 

KAHN, EDWARD, M.D. 

213-16 85th Ave., Queens Village. N. Y. 
KAIN, HELEN G., M.D. 

1801 Eye Street, N.W.. Washington, D. C. 
KARNAKY, KARL JOHN. M.D. 

329 Medical Arts Bldg., Houston 2. Tex. 
KAUFMAN. SHERWIN A.. M.D. 

935 Park Ave.. New York 28. N. Y. 
KERNODLE, JOHN ROBERT. M.D. 

Kernodle Clinic. Burlington. N. C. 
KESHIN. JESSE G., M.D. 

610 West llOth St., New York. N. Y. 
KINGMAN, H. E.. D.V.M. 

Wyoming Hereford Ranch, Cheyenne. Wyo. 
KIRKENDALL, HENRY L.. M.D. 

50 Elm St.. Worcester. Mass. 
KLEIN, JOSEPH. M.D. 

80 Farminghton Ave.. Hartford. Conn. 
KOHN. ANTHONY, MD. 

111 Carlton Ave.. Islip Terrace. L. I., N. Y. 
KRAMER. MILTON, M.D. 

1263 President St., Brooklyn 13. N. Y. 
KREBS, O. S.. M.D. 

3720 Washington Blvd., St. Louis, Mo. 
KUPPERMAN, HERBERT S., M.D. 

477 Ist Ave.. New York 16. N. Y. 
KURLAND. IRVING I.. M.D. 

1265 President St.. Brooklyn 13, N. Y. 
KURZROK. LAWRENCE. M.D. 

969 Park Ave., New York, N. Y, 

14 



KUSHNER, J. 
1840 Grand 



IRVING. M.D. 
Concourse. New 



York, N. Y. 



LANGSTON. HENRY J.. M.D. 

Main St. and Jefferson Ave., Danville, Va. 
LATTUADA. HENRY P.. M.D. 

101 W. North St.. Danville, 111. 
LEARY. DEBORAH, M.D. 

School of Medicine, Univ. of North Carolina 

Chapel Hill. N. C. 
LEIBOLD. GEORGE. M.D. 

818 Cedar Ave.. Pittsburgh, Pa. 
LENNOX, ARTHUR L., M.D. 

1838 Parkwood Ave.. Toledo. Ohio 
LEVENTHAL, MICHAEL. M.D. 

109 N. Wabash St., Chicago, 111. 
LORIMER. ROBERT. M.D. 

148 State St., Portland, Me. 
LUCAS, J. F., M.D. 

501 W. Washington St., Greenwood. Miss. 
LUKEMAN. H. J., M.D. 

285 Casa Linda Plaza, Dallas 18, Tex. 
LYON. ROBERT A.. M.D. 

2533 Ocean Ave.. San Francisco. Calif. 

MARGOLESE, M.S.. M.D. 

436 N. Roxbury Dr.. Beverly Hills. Calif. 
MARSH. EARLE M.. M.D. 

490 Post St.. San Francisco 2. Calif. 
MASSEY. WARREN E.. M.D. 

1538 Medical Arts Bldg., Dallas, Tex. 
MATSNER, ERIC M.. M.D. 

450 N. Bedford Dr.. Beverly Hills, Calif. 
McCALL. MILTON L.. M.D. 

Louisiana State Univ.. New Orleans, La. 
McCORMICK. CHARLES O.. JR.. M.D. 

3843 Central Ave., Indianapolis, Ind. 
McDONOUGH. JOHN J.. M.D. 

11 Central Square. Youngston. Ohio 
McENTEE. KENNETH. D.V.M. 

New York State Veterinary College at Cornell 

Univ., Ithaca. N. Y. 
MENCARO. WILLIAM JOSEPH. M.D. 

505 15th. Moline, 111. 
MENDEL, EVRI B., M.D. 

3702 Worth, Dallas, Tex. 
MEZER, JACOB. M.D. 

The Lister Bldg.. 475 Commonwealth Ave.. 

Boston, Mass. 
MILLEN, ROBERT S. 

Westbury, N. Y. 
MITCHELL, GEORGE J., M.D. 

1322 Springhill Ave., Mobile, Ala. 
MITCHELL, GEORGE W., JR.. M.D. 

30 Bennet St., Boston. Mass. 



15 



MONTGOMERY. JOHN B.. M.D. 

1930 Chestnut St., Philadelphia, Pa. 
MORGENSTERN, MATES, M.D. 

127 LivingTston Ave., New Brunswick, N. J. 
MORSE, WALTER 8., M.D. 

3411 Montrose Blvd.. Houston 6, Tex. 
MYLKS, G. W.. JR.. M.D. 

122 Wellington St., Kini^ston, Ontario, Canada. 
MYLLER, ERNEST, M.D. 

66 E. 76th St., New York, N. Y. 

NATHANSON, ESTHER A., M.D. 

2535 Massachusetts Ave., N.W., Washington 8, D. C. 
NISWANDER, KENNETH. M.D. 

412 Linwood Ave., Buffalo, N. Y. 
NORWOOD, G. E., M.D. 

1406 S. San Marino Ave, San Marino 9, Calif. 
NYDA. MORTON J., M.D. 

666 Sutter St., San Francisco, Calif. 

OGLE, LUTHER CURTIS, M.D. 

188 S. Bellevue St., Suite 306, Memphis, Tenn. 

PARKS, THOMAS J.. M.D. 

47 E. 63rd St., New York 21, N. Y. 
PATTEE. CHAUNCEY J., M.D. 

1390 Sherbrooke St., W., Montreal, Canada 
PEARSE. RICHARD L., M.D. 

604 W.. Chapel Hill. Durham, N. C. 
PERLMAN, ROBERT M., M.D. 

999 Sutter St., San Francisco. Calif. 
PERSALL. JOHN T., M.D. 

302 S.F.C. Bldfi:., Auffusta. Ga. 
PETERS, WILLIAM A.. JR., M.D. 

206 S. Road St., Elizabeth City, N. C. 
PEVEN, PHILIP S., M.D. 

18709 Meyers Rd., Detroit 36, Mich. 
PLATZ, CAROL. M.D. 

1368 Kelly Rd.. Detroit 24. Mich. 
PORTNOY, LOUIS, M.D. 

28 W. llth St., New York 11, N. Y. 
POWELL, NORBORNE B.. M.D. 

801 Hermann Professional Bldfi:.. Houston 26, Tex. 

RAND. ANNA T., M.D. 

1801 Emerson St., N.W., Washington, D. C. 
RENNIE, S.W., M.D. 

1201 Delaware Ave., Wilminarton, Del. 
RIESER, CHARLES, M.D. 

819 Cypress St., N. E., Atlanta, Ga. 
RIEMENSCHNEIDER. E., M.D. 

1000 2nd National Bldfir., Akron, Ohio 
ROBERTSON. JARRETT. M.D. 

609 Medical Arts Bldg., Birmingham, Ala. 

16 



ROGERS, JOSEPH. M.D. 

171 Harrison Ave., Boston, Mass. 
ROLAND, MAXWELL, M.D. 

11420 Queens Blvd.. Forest Hills. N. Y. 
ROMBERG. GEORGE H.. M.D. 

145 Maple Ave., White Plains, N. Y. 
ROMBERGER. FLOYD T., JR.. M.D. 

3440 No. Meridian St., Indianapolis, Ind. 
ROSENBLUM. GORDON. M.D. 

6333 Wilshire Blvd.. Los Angeles 48, Calif. 
ROSENFELD. S. S., M.D. 

1882 Grand Concourse, New York, N. Y. 
ROTH, DANIEL B.. M.D. 

886 Garrison Ave.. Teaneck, N. J. 
ROTHMAN. EMIL. M.D. 

722 Maccabees Bldg.. Detroit. Mich. 
RUSSELL. MURRAY, M.D. 

8820 Wilshire Blvd., Beverly Hills, Calif. 

SAPHIRSTEIN, HYMAN, M.D. 

479 Beacon St.. Boston, Mass. 
SCHAEFFER. FRANCES C, M.D. 
26 N. Eight St., AUentown. Pa. 
SCHINFELD. LOUIS. M.D. 

256 S. 17th St., Philadelphia, Pa. 
SCHNALL, MEYER D., M.D. 

130 E. 67th St., New York, N. Y. 
SCHRÄM, E. L. R., M.D. 

604 Wellington St., London, Ontario, Canada. 
SCHULTZ, JOHN M., M.D. 

604 Huntington Bldg., Miami 82, Fla. 
SCOTT, JOSEPH W., M.D. 

742 Dupont Bldg.. Miami, Fla. 
SEIBEL. DAVID. M.D. 

University Hospital. Minneapolis, Minn. 
SEITCHIK. JOSEPH N.. M.D. 

230 N. Broad St.. Philadelphia. Pa. 
SELTZER, LEO MAURICE. M.D. 

1205 Quarrier St., Charleston. W. Va. 
SHIMMERLIK. LUCH. M.D. 

155 E. 73rd St., New York. N. Y. 
SIEGLER. ALVIN M.. M.D. 

706 Eastem Parkway, Brooklyn, N. Y. 
SILTON, MAURICE Z., M.D. 

5720 Wilshire Blvd.. Los Aengeles 36, Calif. 
SIMMONS. RAYMOND. M.D. 

37-39 N. Goodman St.. Rochester, N. Y. 
SINCLAIR. A. B.. M.D. 

4711 Central St.. Kansas City. Mo. 
SKEELS. ROBERT. M.D. 

921 Westwood Blvd.. Los Angeles. Calif. 
SMITH. SAMUEL W.. M.D. 

6638 Telegraph Ave.. Oakland. Calif. 
SNOW, LUCILLE H., M.D. 

686 Church St., Wilmette. 111. 

IT 



SORDO-NORIEGA, ANTONIO, M.D. 

Vallarta No. 16, Mexico City, Mexico. 
SORY, J. R., M.D. 

535 S. Flagler Dr., West Palm Beach, Fla. 
SPECK, GEORGE, M.D. 

2808 S. Randolph St., Arlingrton 6, Va. 
SPICER, ROBERT T., M.D, 

Dean, School of Medicine, University of Miami, 

Coral Gables, Fla. 
STEIN, ANNA A., M.D. 

55 Forest Ave., Staten Island 1, N. Y. 
STEINBERG. WERNER, M.D. 

35 Gesner St., I^inden, N. J. 
STEINER, MELVIN D.. M.D. 

209 Medical Arts Bldg., New Orleans. La. 
STEPHENSON. GATTON A., M.D. 

92 Amherst St., Garden City, L. I.. N. Y. 
STEVENSON, CHARLES, M.D. 

1405 Kales Bldg., Detroit 26, Mich. 
STOLLMAN. BERNARD, M.D. 

8220 Wilshire Blvd.. Beverly Hills, Calif. 
STONE. BARTLETT H.. M.D. 

1101 Beacon Street. Brookline 46, Mass. 
STONE, MARTIN L., M.D. 

New York Medical College, Fifth Ave. at 106th 

St., New York 29. N. Y. 
STRASSMANN. ERWIN O.. M.D. 

1405 Hermann Prof. Bldg., Houston 2. Tex. 
STREET. R. A.. JR., M.D. 

The Street Clinic, Vicksburg, Miss. 
SUGGS, WILLIAM D., M.D. 

Monument Ave. and Lombardy St., Richmond, Va. 

TAFEEN. CARL H., M.D. 

9 Pierre Pont St., Brooklyn, N. Y. 
TANZ, ALFRED, M.D. 

288 Crown St., Brooklyn, N. Y. 
TARTA. GIRO, M.D. 

654 E. 18th St., Paterson, N. J. 
TAYMOR, MELVIN L., M.D. 

330 Darthmouth St., Boston, Mass. 
TIETZE, CHRISTOPHER. M.D. 

2532 Holmes Run Dr., Falls Church, Va. 
THOMAS, LEON B., M.D. 

1206 S. llth St., Tacoma, Wash. 
TOPKINS, PAUL, M.D. 

1141 Eastern Parkway, Brooklyn. N. Y. 
TRUEX. S. ALLEN. M.D. 

Truex Clinic, Jackson. Tenn. 
TRYTHALL, S. W., M.D. 

13300 Livernois Ave., Detroit 4. Mich. 

VANN. FELIX H.. M.D. 

242 Engle St., Englewood, N. J. 

If 



VON FOHLE. K. C. M.D. 
1010 Banks. Houston, Tex. 

WAINER, AMOS SHEPARD. M.D. 

1621 Spnice St., Philadelphia 8, Pa. 
WALLIN. S. P.. M.D. 

2615 Capital Ave.. Cheyenne, Wyo. 
WARE. H. HUDNALL, JR., M.D. 

816 W. Franklin St.. Richmond, Va. 
WARD, ELIZABETH, M.D. 

140 Roseville Ave., Newark, N. J. 
WARD. MILDRED E.. M.D. 

59 E. 54th St.. New York, N. Y. 
WARREN, BERNICE. M.D. 

4100 West McNichols Rd., Detroit, Mich. 
WATERS. H. W., M.D. 

730 Adams Ave., MontKomery, Ala. 
WATSON, BLAKE H., M.D. 

10962 LeConte Ave.. Los Angeles 24. Calif. 

Beverly Hills. Calif. 
WEBER, LENNARD L., M.D. 

255 S. I7th St., Philadelphia. Pa. 
WEIL. ALVEN M.. M.D. 

1030 Ist Natl. Tower, Akron. Ohio. 
WEINSTEIN. DAVID. M.D. 

234 S. Main St.. Opelousas, La. 
WEINSTEIN, MORTIMER. M.D. 

1160 Fifth Ave., New York. N. Y. 
WELD, STANLEY B., M.D. 

85 Jefferson St., Hartford. Conn. 
WELDON. JOSEPH. M.D. 

461 Government St.. Mobile. Ala. 
WEXLER. DAVID J.. M.D. 

111 Carlton Ave.. Islip Terrace. Long Island, N. Y. 
WIENER, WILLIAM B., M.D. 

653 N. State St., Jackson. Miss. 
WILLIAMS. GEORGE A.. M.D. 

710 Peachtree St., N.E.. Atlanta, Ga. 
WILSON. LEO. M.D. 

400 West End Ave., New York. N. Y. 
WILSON, ROBERT B., MD. 

102-110 Second Ave., S.W.. Rochester, Minn. 
WIMPFHEIMER, SEYMOUR, M.D. 

1100 Park Ave.. New York 28. N. Y. 
WINEBERG. ANAH CECELIA. M.D. 

3120 Webster St., Oakland 9, Calif. 
WOLLMAN. LEO. M.D. 

2802 Mermaid Ave., Brooklyn. N. Y. 
WORD. BUFORD, M.D. 

2205 Highland Ave., Birmingham, Ala. 

YOUNG, RAYMOND L.. M.D. 

241 Washington Ave.. SanU Fe, N. M. 



19 



ZELLERMAYER. J.. M.D. 

609 Professional Bldgr,, Kansas City, Mo. 
ZETTELMAN. HENRY J., M.D. 

1432 Aeburgr Ave.. Evanston, 111. 



CORRESPONDING MEMBERS 

AHUMADA, JUAN C, M.D. 

Charcas 2346, Buenos Aires, South America 
ASHERMAN, JOSEPH G., M.D. 

29 Idelson St.. Tel-Aviv. Israel 
AVERILL, L. C. L.. M.D. 

83 Bealey Ave., Christchurch. N. Z. 

BAYLE. HENRI, M.D. 

193 Boulevard St. Germain, Paris, France 
BECLERE, CLAUDE. M.D. 

23. Rue d'Artois. Paris (Seme), France 
BERGE. TEN, M.D. 

Academisch Ziekenhuis, Groningen. Netherlands 
BETTINOTTI, ALBERTO, M.D. 

Rivere Indarte 21, Buenos Aires. South America 
BOTTELLA-LLUSIA, JOSE. M.D. 

Velazquez 83, Madrid, Spain 
BREA. CESAR A., M.D. 

Santa Fe 1391, Buenos Aires, Argentina 

CARRIZO, ARISTOBULO, M.D. 

Centro Medico Box 1615, Panama, Panama 
CHEVALIER, PAOUL M. 

Sante Fe 1707, Buenos Aires, Argentina 

DA PAZ FIHLO, A. CAMPOS, M.D. 

Rua Sao Jose, No. 50 40qandar 

Rio de Janeiro, Brazil 
DE ANDRADE, CLAUDIO, M.D. 

Baras Jaguerico, 275, Rio de Janeiro. Brazil 
DE LA BALZE, FELIPE, M.D. 

1083 Parana St., Buenos Aires, Argentina 
DE BARROS, PAULO, M.D. 

Rue Alcindo Guanabara, Rio de Janeiro, Brazil 
DE MORAES, ARNALDO. M.D. 

Caixa Postal No. 1289. Rio de Janeiro. Brazil 
DE MUYLDER. EDGARD, M.D. 

Avenue General de Gaulle 36. Brüssels. Belgium 
DE REZENDE. JORGE. M.D. 

92, Rua Xavier Da Silveira. Rio de Janeiro. Brazil 
DE WATTEVILLE. HUBERT. M.D. 

6, Rue Charles Bonnet. Geneva. Switzerland 
DI PAOLA. GUILLERMO. M.D. 

Vidt 2061, Buenos Aires, Argentina 

GRANT. ALAN, M.D. 

147 Macquarie St., Sydney, Australia 

20 



HAMMEN, RICHARDT H.. M.D. 

Jarmersgade 2. Copenhagen, Denmark 
HERRERA, ROBERTO GANDOLFO. M.D. 

1592 San Juan St., Buenos Aires. Argentina, S. A. 

JOEL, CHARLES A., M.D. 

4, Zvishapira St., Tel Aviv, Israel 

LAGERLOF. PROF. NILS 

Royal Veterinary College, Experimental Faltet, 

Stockholm. Sweden 
LOPEZ, MANUEL B.. M.D. 

Calle Yi. 1219. Montevideo, Uruguay 
LOUYOT, JEAN, M.D. 

25 Baron Louis St., Nancy, France 

MADSEN, VALDEMAR, M.D. 

16 Juliane Maries Ves, Copenhagen, Denmark 
MEZZADRA, JOSE MARIA E.. M.D. 

Pampa 2540, Buenos Aires, Argentina, S. A. 
MORI-CHAVEZ, PABLO. M.D. 

Negreiros 563, Lima, Peru, S. A. 
MURRAY, EDMUNDO G.. M.D. 

Ayacucho 1376. Buenos Aires, Argentina 

NOBILE. TIMETEO. M.D. 

Via Sabaudia 14, Torino, Italy 
NORDLANDER, ERIC. M.D. 

Grev Turegatan 86, Stockholm, Sweden 
NOUEL, CARLOS. M.D. 

Avenida Buenos Aires, Caracas. Venezuela, S. A. 
NUNEZ, ANTONIO CLAVERO, M.D. 

Gran Via Fernando el Catolico 27, pral., Valencia. 

Spain 

PALMER, RAOUL, M.D. 
3 Rue Octave Feuillet. Paris, France 
PENA. DE LA, ALFONSO 
Padilla 22, Madrid, Spain 

RABAU. ERWIN. M.D. 

8 Megidoser. Tel Aviv, Israel 
RAO, B. K., M.D. 

S-K Connaright Place, New Delhi, India 
RYDBERG. ERIK. M.D. 

Juliane Mariesvej 18, Copenhagen, Denmark 

SHARMAN, ALBERT, M.D. 

19 Kelvin Crt., Glasgow, Scotland 
SOLOMONS, EDWARD, M.D. 

80 Fitzwilliams PI., Dublin, Ireland 

TRABUCCO, ARMANDO E.. MD. 

Rivadavia 1917, Buenos Aires, Argentina, S. A. 

tl 



VANDEVELDE. PETER. M.D. 

108, Ave. J. Van Ryswyck, Antwerp, Belffium 
VERAIN. MARCEL, M.D. 

68 bia Rue de la Commandier, Nancy, France 

YOUNG, DONALD. M.D. 

50 Rodney St.. Liverpool, Lancashire, England 



I 



22 



GEOGRAPHICAL INDEX 



ALABAMA 

Brannon, Robert M. 
Branscomb. Louise 
Brown. Hunter 
Buerger, Claude L. 
Cline, Wade 
Dabney, Marye Y. 
Douglas, Gilbert F. 
Goldner, Harry 
Harsh, John F. 
Jones, W. Nicholson 
Mitchell, George J. 
Robertson, Jarrett 
Thomas, Herbert H. 
Waters, H. W. 
Weldon, Joseph 
Word, Buford 

ARKANSAS 

Brown, Willis E. 
Dodge, Eva F. 

CALIFORNIA 

LOS ANGELES and 
BEVERLY HILLS 

Belt, Eimer 
Glass, Samuel J. 
Harris, Joseph 
Margolese, M. S. 
Matsner, Eric M. 
Payne, Sheldon 
Rosenblum, Gordon 
Russell, Murray 
Silton, Maurice Z. 
Skeels, Robert 
Stollman, Bernard 
Tyler, Edward T. 
Watson, Blake H. 

SAN FRANCISCO and 
BERKELEY 

Biskind, Gerson R. 
de Carlo, Donald W. 
Fluhman, C. Frederic 
Hadden, David Rodney 
Haman, John O. 
Hinman, Frank. Jr. 



Howard, Frederick S. 
Jennings, Agnes F. 
Lyon, Robert A. 
Marsh, Earle M. 
Michelson, Lewis 
Myda, Morton 
Palmer. Allan 
Page. Ernest 
Perlman. Robert M. 
Tompkins. Pendieton 
Vollmer. Albert M. 
Whitelaw, Maurice J. 

OTHER CITIES 

Cantor. Edward 
Norwood. G. E. 
Shields. Frances E. 
Smith. Samuel W. 
Wineberg. Anah C. 

COLORADO 

Freed. Charles 
Frosh. Alvin J. 
Gersh. Isadore 
Mason, Lyman M. 

CONNECTICUT 

Biskind, Morton 
Brand, EUiott 
Carrabba, Salvatore 
Corcoran, Michael A. 
Goldfried, Milton S. 
Jacobson, Charles E. 
Johnson, Carl E. 
Klein, Joseph 
Hepbum, Robert H. 
Weld. Stanley B. 

DELAWARE 

Pollak, Otakar J. 
Rennie, S. W. 

DIST. OF COLUMBIA 

Dodek, Samuel M. 
Fogel, Julius 
Henkln, Allen E. 
Nathanson, Esther A. 
Rand, Anna T. 
Kain, Helen G. 



23 



FLORIDA 

Anslander, Harold P. 
Chrisman, R. B. 
Coehrane. Cleland 
Doufirlas. Joseph W. 
Forman, Richard C. 
Sory, J. R. 
Schultz, John M. 
Spicer, Robert 

GEORGIA 

Chappell, Amey 
Goodman, Leon J. 
Greenblatt, R. B. 
Persall, John T. 
Rieser, Charles 
Williama, Georsre A. 

IDAHO 

Hulme. Harold B. 

ILLINOIS 

CHICAGO 

Benesohn, Sol. 
Cohen, Melvin R. 
Davis, M. Edward 
Dobson, Catherine L. 
Frank, Richard 
Greenhill, J. P. 
Heckel, Norris J. 
HeiTold, Russell D. 
Huffman, John W. 
Leventhal, Michael 
Rubenstein, Boris B. 
Stein, Irvinjf F. 
Thompson, Willard O. 

OTHER CITIES 

Danforth, David 
Dickerson, Donald L. 
Garrett, Sherman S. 
Lattuada, Henry P. 
Mencarrow, William J. 
Snow, Lucille 
Zettelman, Henry J. 

INDIANA 

Cortese, Thomas A. 
McCormick, C. C, Jr. 
Romberfirer, Floyd T., 
Jr. 



IOWA 

Nelson, Warren 
Stuermer, Virginia M. 

KANSAS 

Dieter. Donald D. 

KENTUCKY 

Gray, Laman A. 

LOUISIANA 

Davis, Julius 
Getzoff , Paul L. 
Goldman, Daniel W. 
Johnson, C. Gordon 
McCall, Milton L. 
Steiner, Melvin D. 
Weed, John C. 
Weinstein, B. B. 
Weinstein, David 

MAINE 

Coulton, Donald 
Lorimer, Robert 

MARYLAND 

Jones, G. E. Segar 

MASSACHUSETTS 

BOSTON and 
BROOKLINE 

Abramson, Daniel 

Albert, Louis 

Brodny, M. Leopold 

Doyle, Joseph B. 

Ingersoll, Francis M. 

Mezer, Jacob 

MeiRS. Joe V. 

Mitchell, Georife W. 

Mulliean, William J. 

Rock, John 

Rogers, Joseph 

Saphirstein, Hjnnan 

Simmons, Fred A., Jr. 

Stone, Bartlett 

Sturgis, Somers H. 

Taymor, Melvin L. 

OTHER CITIES 

Beldinsr, David L. 
Burke, John E. 
Kirkendall, Henry L. 
WiUiams, Walter W. 



24 



MICHIGAN 

Andres, George J. 
August, Ralph V. 
Behrman, Samuel J. 
Berlin, Allen 
Mack, Harold C. 
Peven, Philip S. 
Platz, Carol 
Rothman, Emil 
Stevenson, Charles 
Trythall, S. W. 
Warren, Bemice 

MINNESOTA 

Albert, A. 
Fortier, Quincy E. 
Freidman, Louis L. 
Garske, George Leo 
Green, Lawrence 
Hodgson, Jane E. 
Seibel, David 
Wilson, Robert B. 

MISSISSIPPI 

Lucas, J. F. 
Street, R. A., Jr. 
Wiener. William B. 

MISSOURI 

Carlson, Hjalmar 
Crossen, Robert J. 
Hartnett, Leo J. 
Krebs, O. S. 
Masters, William H. 
Singleton, J. Milton 
Zellermayer, J. 

MONTANA 

Howard, Lawrence L. 

NEBRASKA 

Anderson, Harley 
Stuermer, Virginia M. 

NEW JERSEY 

Finklcr, Rita S. 
Berman, Robert 
Cannis, John P. 
Hartman, Carl G. 
Frost, Inglis F. 
Morgenstern, Mates 
Rommer, J. Jay 
Roth, Daniel B. 



Steinberg. Werner 
Tarta, Giro 
Vann, Felix H. 
Ward, Elizabeth 
Reifenstein. E. C, Jr. 

NEW MEXICO 

Young, Raymond L. 

NEW YORK 

NEW YORK CITY and 
BROOKLYN 

Byron, Charles 
Chidester, Augustus B. 
Buxton, Charles L. 
einer. Leonard F. 
Crawley, Lawrence O. 
Daniels, Anna K. 
Decker, Albert 
Engle, Earl T. 
Fischer, Irving C. 
Folsome, Clair E. 
Freedman, Henry 
Gepfert, Randolph 
Gorbea. Ricardo L. 
Goldfarb, Alvin 
Greeley, Arthur V. 
Guttmacher, Alan F. 
Hollander, Arthur 
Hotchkiss, Robert S. 
Kaufman, Sherwin A. 
Keshin, Jesse G. 
Kleegman, Sophia J. 
Kramer, Milton 
Kupperman, Hebert S. 
Kurland, Irving I. 
Kurzrok, Lawrence 
Kurzrok, Raphael 
Kushner, J. Irving 
MacLeod, John 
McLane, Charles M. 
Milien, Robert S. 
Myller, Emest 
Papanicolaou, G. N. 
Parks, Thomas 
Portnoy, Louis 
Rosenfeld, S. S. 
Rubin, Isidor C. 
Salmon. Udall J. 
Schnall, Meyer D. 
Shimmerlik, Lucy 
Sicgler, Alvin M. 
Stein, Anna A. 
Stone. Abraham 



26 



h 



Stone, Martin L. 
Tafeen, Carl H. 
Tanz, Alfred 
Topkins, Paul 
Ward, Mildred E. 
Weinstein, Mortimer 
Weisman, Abner I. 
Wexler, David J. 
Wilson, Leo 
Wimpfheimer, Seymour 
Wollman, Leo 

OTHER CITIES 

Benjamin, John 
Birnberg, Charles H. 
Feldman, Harold 
Fincher, Myron G. 
Fond, Morris S. 
Heckel, George P. 
Hellman, Louis M. 
Hughes, Edward C. 
Kahn, Edward 
Kohn, Anthony 
McEntee, Kenneth 
Niswander, Kenneth 
Pommerenke, W. T, 
Roland, Maxwell 
Romberg, George H. 
Simmons, Raymond 
Stephenson, (iatton A. 

NORTH CAROLINA 

Carter, Bayard 
Hamblen, Edwin C. 
Kernodle, John Robert 
Leary, Deborah 
Pearse, Richard L. 
Peters, William A. 
Turner, Violet H. 

NORTH DAKOTA 

Hunter. G. Wilson 

OHIO 

Bennett, Alwne E. 
Efstation, Thomas D. 
Garber, Stanley 
Hoffman, Kathryn E. 
Lennox, Arthur L. 
McDonough, John J. 
Roth, Arthur A. 
Silbernagel, Wynne M. 
Weil, Alven M. 
Weir, David R. 
Weir. William C. 



OKLAHOMA 

Howard, R. Palmer 

OREGON 

Heller, Carl G. 
Emmons, Carl W. 

PENNSYLVANIA 

PHILADELPHIA 

Angelucci, Helen M. 
Castallo, Mario A. 
Charny, Charles 
Cristol, Davis S. 
F'arris, Edmond J. 
First, Arthur 
Forman, Isador 
Fried, Paul H. 
Hahn, George A. 
Israel, S. Leon 
Marbach, A. Herbort 
Mazer, Charles 
Montgomery, John B. 
Perloff, Wm. H. 
Rakoff, Abraham E. 
Schinfeld. Louis 
Seitchik, Joseph N. 
Wainer, Arnos Shepard 
Weber, Lennard L. 

OTHER CITIES 

Arnheim, Falk K. 
Finegold, W. J. 
Hance, B. M. 
Leibold, George 
Schaeffer, Frances C. 

TENNESSEE 

Black, William T. 
Ogle, Luther Curtis 
Truex, Allen 

TEXAS 

Crutcher, H. K. 
Dippel, A. Louis 
Eßsin, Emmett 
Guerriero, William F. 
Jinkins, J. L. 
Kantor, Herman I. 
Karnaky, Karl John 
Lukeman, H. J. 
Massey, Warren E. 
Mendel, Evri B. 
Morse, Walter S. 



26 



Powell. Norbome B. 
Strasmann, Erwin O. 
Von Pohle, K. C. 
Goldzier, Joseph 

UTAH 

Fister, George M. 

VIRGINIA 

Bickers, William 
Längsten, Henry J. 
Speck, George 
Suggs. WiUiam D. 
Tietze, Christopher 
Ware. H. H.. Jr. 

WASHINGTON 

Banks, Lawrence 
Blandau, Richard J. 
Frazier, William H. 
Rutherford, Robert N. 
Thomas, Leon B. 

WEST VIRGINIA 

Hudgins, Archibald P. 
Seltzer. Leo Maurice 

WYOMING 

Kingman, H. E. 
Wallin, S. P. 

ARGENTINA 

Ahumada, Juan C. 
Bettinotti, Alberto 
Chevalier, Raul M. 
Brea, Cesar A. 
de la Balze, Felipe 
di Paola, GuUermo 
Herrera, Roberto G. 
Mezzadra, Jose M. E. 
Murray, Edmundo G. 
Trabucco. Armande E. 

AUSTRALIA 

Grant. Alan 

BRAZIL 

da Paz Fllho. A. C. 
de Andrade, Claudio 
de Barros, Paulo 
de Moraes, Amaldo 
de Rezende, Jorge 



BELGIUM 

DeMuylder, Eduard 
Vandevelde, Peter 

CANADA 

Barker, C. A. V. 
Mylks, G. W., Jr. 
Pattee, Chauncey J. 
Roberston, Edwin M. 
Schräm, E. L. R. 
Shute. Evan V. 

DENMARK 

Mammen, Rlchardt H. 
Madsen, Valdemar 
Rydberg, Erik 

ENGLAND 

Lane-Roberts, Cedric S. 
Young, Donald 

FRANCE 

Bayle, Henri 
Beclere, Claude 
Louyot, Jean 
Palmer, Raoul 
Verain, Marcel 

INDIA 

Rao, B. K. 

IRELAND 

Solomons, Edward 

ISRAEL 

Asherman, Joseph G. 
Joel. Charles A. 
Rabau, Erwin 

ITALY 

Nobile, Timoteo 

MEXICO 

Alvarez, Bravo. Alfonso 
Arzac, Jose P. 
Castro, Eduarde 
Gallo, Delfino 
Guerrero, Carlos D. 
Guerra, Salas 
Sordo-Moriega, Antonio 
Young, Raymond L. 



27 



NETHERLANDS 

Rerge, Ten 

NEW ZEALAND 

AveriM. L. C. L. 

PANAMA 

Carrizo, Aristobulo 

PERU 

Muri-Chavez, Pablo 

SALVADOR 

Guerrero, Jose G. 

SCOTLAND 

Sharman, Albert 



SPAIN 

Butelhi-Iilusia. Jose 
Nuni'z, Antonio C. 
•ic la Pcna. Alfnnso 

SWEDEN 

T,affcrl<)f, NÜH 
Nordländer, Eric 

S WITZERLAND 

De Watteville, Hubert 

URUGUAY 

Lopez, Manuel B. 

VENEZUELA 

Nouel, Carlos 



28 



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CITY OF NEW YORK 

DEPARTMENT OF HOSPITALS 

125 WORTH STREET 

NEW YORK 13. N. Y. 



MARCUS D. KOGEL. M. D. 
COMMISSIONER 



Dr« Em est Mylier 
65 East 7mh Street 
Wew iork City 



December 5, 1955 



•. n. 402 



[ 



Dear I^octor Mylier: 

On the recommendatioE of 
the Medical Board of Gouverneur Hospital, 
you are promoted to Associate Visit icg 
ObstetriciäD-GyDecologist, affective 
September 9, 1955. 



itruly yours. 



MDK:din8 




f, M.D. 
Commis sloner 



«-•*.i-»-rf(is*i^««iw^«SfC-J«^je>*»'i:*j'«t«i*3*:^swp-'- .-rai^-'-r^ - -■■ a"t^» -< Wn » ■•^wtfe-«*»»-^.- -. ■• -.*"«<*:-' 



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AMERICAN ACADEMY OF OBSTETRICS AND GYNECOLOGY 

Office of C. Paul Hodgkinson, M.D., Secretary 

116 South Michigan Avenue 

Chicago 3, Illinois 



September l8, 1953 



Ernest Myller, M.D. 
65 East 76th Street 
New York 21, New York 

Dear Doctor Myller: 

It gives me great pleasure to inform you that the Executive 
Board of the American Academy of Obstetrics and Gynecology 
has elected you a Fellow of the Academy. 

This election is contingent, of course, upon receipt of your 
check for $50 in payment of your initiation fee of $25 and 
your 1953 dues $25. 

It is hoped that your participation in the Academy and its 
activities will be a continuing source of mutual advantage 
and pleasure. 

I look forward to seeing you at Coming meetings. 



Very sincerely yoin*s. 



^.c£ 




CPH:ac 



C. Paul Hodgkinson'T^M.D. 
Secretary 



i 



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PRESIDENT 

Robert A. Kimbrouch, Je., MD. 
807 Spnice Street 
Philadelphia 7, Pennsylvania 

IMMEDI ATE FAST PRESIDENT 

Carl P. Huber, M.D. 
1040 West Michigan Street 
Indianapolis 7, Indiana 

IST VICE PRESIDENT 
Howard Stearns, M.D. 
833 S. W. Eleventh Ave. 
Portland S, Oregon 

2ND VICE PRESIDENT 

Joe Vincent Meios, M.D. 
Vincent Memorial Hospital 
Boston, Massachusetts 



PRESIDENT ELECT 

Bayard Carter, M.D. 
Duke Hospital 
Durham, North Carolina 

TREASURER 

Herbert E. Schmifz, M.D. 
55 E. Washington Street 
Chicago 2, Illinois 

SECRETARY 

Ci -Paul Hodckinson, M.D. 

17546 Meadowood, Lathrup Village 
Birmingharn, Michigan 

ASSISTANT SECRETARY 
: Charles D. Kxmbaix, M.D. 
734 Broadway 
Seattle 22, Washington 



Chairwnn of Districi I 

Samuel B. KnutwooD, M.D. 
1180 Beacon Street 
Brookline 46, Massachusetts 



Chairman of Districi V 

Allan C. Barnes, MJ>. 

2065 Adelbert Road 
Cleveland 6, Ohio 



Chairman of District JI 

Edward C. Httches, M.D. 
713 E. Genescc Street 
Syracuse 2, New York 



Chairman of District VI 

John I. Brewer, M.D. 
104 S. Michigan 
Chicago 3, Illinois 



Chairman of District III 

JoiiN B. Montgomery, M.D. 
1930 Chestnut Street 
Philadelphia 3, Pennsylvania 



Chairman of District VII 

Wllllxm f. Mengert, M.D. 
2211 Oak Lawn 
Dallas 4, Texas 



Chairman of District IV 
John Parks, M.D. 
901 23rd Street, N.W. 
Washington 7, D. C. 



Chairman of District VIII . 
R. Glenn Craig, M.D. 
490 Post Street 
San Francisco 2, California 



EXECUTIVE SECRETARY, Mr. Donald F. Richardson, 116 South Michigan, Chicago 3, Illinois 



n 



NEW YORK UNI VERSITY- BELLEVUE MEDICAL CENTER 



OF NEW YORK UNIVERSITY 

477 FIRST AVENUE. NEW YORK 16, N.Y. 

OREGON 9-3200 



BOARD OF TRUSTEES 

WINTHROP ROCKEFELLER. Chairman 

SAMUEL A. BROWN, M.D.. Vict-Chairman 

LEROY E. KIMBALL. Secrttary-Tctaiurtr 

GEORGE A. BROWNELL 

HARRY WOODBURN CHASE 

HARRIS A, DÜNN 

NEVIL FORD 

F. ABBOT GOODHUE 

CHARLES C. HARRIS 

O. V. W. HAWKINS 

RUSH H. KRESS 

SAMUEL D. LEIDESDORF 

CHARLES S. MCVEIGH 

BAYARD POPE 

JOHN M. SCHIFF 



June 29, 1951 



OFFICERS OF ADMINISTRATION 

EDWIN A. SALMON. Dirtctor 
DONAL SHEEHAN. M.D., Chairman 

Scientific Committte 
CURRIER MCEWEN. M.D.. Dtm 

College of Medicine 
ROBERT ßOGGS, M.EX. Dean 

Post-Craduate Mediail Scboot 
EDWARD M. BERN ECKER. M.D. 

Hospital Administrator 
EDGAR S, TILTON. Executiut Secrelary 



Dear Doctor Myller: 

You are hereby advised that the Board of Trustees at 
a meeting held June 19, 1951 approved and confinned your re- 
appointment to the University Hospital staff as hereinafter 
set forth: 

Title: Assistant In Obstetrics and Gynecology 
Period: Effectivc September 1, 1951 

It is understocd that all staff appointments shall 
be for periods not in excess of one year, and shall terminate 
on August .?lst of each year thereafter following the commence- 
ment of service linder the appointment, orovided however, that 

all such appointments shall be subject to the right of the 
Board of Trustees to modify or cancel the terms of service at 
any time in the event that conditions make such action desir- 
able, the decision of the Board as to the desirability of such 
action being final. 

Sincerely yours. 



I 



Secretary-Treasurer 
(100 Washington Souare Eest) 



Doctor Emest Myller 
65 East 76th Street 
New York 21, New York 



% 



...t^^sdima 



n 



NEW YORK UNIVERSITY-BELLEVUE MEDICAL CENTER 

OF NEW YORK UNIVERSITY 

477 FIRST AVENUE, NEW YORK 16. N.Y. 

OREGON 9-3200 



BOARD OF TRUSTEES 

WINTHROP ROCKEFELLER. Chairman 

SAMUEL A. BROWN. M.D.. Vice-Chairman 

LEROY E. KIMBALL, Secrelary-Treaturtr 

GEORGE A. BROWNELL 

HARRY WOODBURN CHASE 

HARRIS A. DÜNN 

NEVIL FORD 

F. ABBOT GOODHUE 

CHARLES C. HARRIS 

O. V. W. HAWKINS 

RUSH H. KRESS 

SAMUEL D. LEIDESDORF 

CHARLES S. MCVEIGH 

BAYARD POPE 

JOHN M. SCHIFF 



June 9, 1950 



OFFICERS OF ADMINISTRATION 

EDWIN A. SALMON. Director 
DONAL SHEEHAN. M.D., Chairman 

Scientific Committee 
CURRIER MCEWEN, MD., Dean 

College of Medicine 
ROBERT BOGGS, M.D., Dean 

Post-Graduate Medical School 
EDWARD M. BERNECKER, M.D., Hoipital Administrator 
EDGAR S. TILTON, Executive Secretary 



I 



Dear Dr, Fyllert 

You are hereby advised that the Board of Trustees at 
a meeting held May 9, 1950 approved and confirmed your 
appointment to the University Hospital staff as hereinafter 
set forth: 

Title: Assistant In Obstetrics and Gynecology 
Period: Effective September 1, 1950 

It is understood that all staff appointments shall 
be for periods not in exe es s of one year, and shall terminate 
on August 31st of each year thereafter following the coramence- 
ment of service under the appointment, provided however, that 
all such appointments shall be subject to the right of the 
Board of Trustees to raodify or cancel the terms of service at 
any time in the event that conditions make such action desir- 
able, the decision of the Board as to the desirability of such 
action being final. 



^ 



Sincerely yours. 




S^retary-Treasurer 
(lOp^ashington Square East) 



Dr. Ernst J-tyll^r 

875 Park Avenue 

New York 21, New York 






....,j^j^y.uit.],ijmi.iiiMi 



^^ 



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*K— 40t 




CITY OF NEW YORK 
DEPARTMENT OF HOSPITALS 

125 WORTH STREET 
NEW YORK 13. N. Y. 



MARCUS D. KOGCL. M. D. 
COMMiaaiONCR 



April 28, 1960 



Dr. Eroest *Äyller 
66 East 76th Street 
üew York 21, N.Y, 

Dear i^octor Myller: 

On the recoEoaendation of 
the Medlcal Board of Gouverneur fioßpital, 
you are hereby appointed Assistant 
^isiting Obßtetrician-Gynecologist, 
effective April 3rr^950. 



llDK:dil8 




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i 



New York Post-Graduate Medical School and Hospital 



303 EAST TWENTIETH STREET 
NEW YORK 3. N.Y. 



Department of Gynecology 
Office of the Executive Officer 



Janu-ry 12, 1949 



Emest ^5ylle^, M.D, 
875 Park Avenue 
New York, Nev; York 

Dear Doctor >6rller: 

Some time in the near future I trust that you will receive 
an appointment as Assistant in Obste tri es and Gynecology to the 
lÄiiversity Hospital, as there will be no further Dispensary 
appointments, 

4 

The assigninents are made by the Chairman of each Department 
and the assignment will be to the Clinic as heretofore, It does 
not carry with it the privilege of admitting private patients to 
the hospital itself • 

Very truly yours, 




Walter ?• Dannreuther, M.D. 

Chairman 

Department of Obstetrics and Gynecology 



WTDinse 



.Jl 



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THE UNIVERSITY OF THE STATE OF NEW YORK 

THE STATE EDUCATiON DEPARTMENT 

ALBANY 



BUREAU OF QUALIFYING CERTIFICATE8 
HORACE L. FIBLD. CHIEF 



Novenbor 18, 1941 



Dr. Ernst MyUer 
383 West End Avenue 
New York, Nev; York 



Dear Sir or Madam: 



A 




itten examlnatlon 
.ers wlth a mark 
lat you may be ex- 



You passed y,o 
In Engllsh for fcireij 
sufflclently hlgh\si^ 
cused from trylng tkhe^xdral examlnatlon. 

You may ^se thls letter as evldence 
that you have^afssed the complete examlna- 
tlon lir\BnK^ for forelgners conducted 
by thls \eiR^tment In October, 1941. 



I 



(• 



r 



Very truly yours 



3/ /"^ 




I 



CPN : AC 



Chief 



2Cn^^c^ ^:^S^^^><^ '^^^^J-'^^^üy^^^^^'K^ ^^^^^^>i^^^ -^^^^^ y^^-^^^c^^ 



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0^3 



1« Hut ±B the dtfliiitioii of postparttai 

2» Ifitbod« of rae«0uriQg blood iMt 

3« Ite iaportmoe of olinieal sigas of hcmorzlMgo 

4* ÜMMiMity of oerrieal inepoetioii 

5« Todtaiiquo of pooking tlio vagiiMif eoxidx end Uterus , and indioatioiui fbr 

6« Obqrtoeie« 

7# luftudoBs ineludiig Intrrrenous pitoitrln 

8« T^ranofasions 

9« ReohoclciBg 

lO, ^jratoroetoRQr • do not weit too loog 

Sbould bo glTon I7 a »omber of the Obatetrioal and Qjrnaoologioal Dapartoiaat* 



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AMERICAN BOARD DF DBSTETRICS AND GYNECDLDGY 



Waltb» T. Dannrbuthe*. M. D„ Niw York, President 
JosBPH L. Babr. M, D., Chicago, lu... Vice President 

Paul Trrus. M. D., PrmBUROH. Pa., Secretary-Treaturer 

NoRUAN F. Miller, M. D., Ann Arbor, Mich. 
Willard R. Cookb, M, D.. Galveiton, Texas. 
F. Batard Carter, M. D., Duhham, N. C. 

Ludwig A. Emgb. M, D., San Francisco. Calif., Vice President 
Edward A. Schumann, M. D., Philadelphia, Pa. 
Robert L. Faulkner, M. D., Cleveland, Ohio. 



/ AGS ^ 
AAOG&AS 
AMA : 



OFnCE OF THE SECRETARY-TREASURER 

PAUL TITUS, M.D. 

1015 HiGHLAhiD Building 

PlTTSBUROH (6), Fa. 



October 2, 1947. 



Emest Myller, M. D. , 

875 Park Avenue, 

New York 21, New York, 

Dear Dr, Myller: 



You made no reply to question 
#11 in your application and it is essential 
for our Gredentials Committee to have this 
Information. It is belng attached below and 
I would appreciate your early attention to 
this matter» 



Yery^Tuly—^f-ows , 





Paul Tltus, M. D. 



PT/adf 



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Dx. Erneßt Hyllei? 
65 Eae-b "76tli Street 
Hew iork 21, 5- !• 



i 



iuj^.^ 



1 



iLOCtmimaaare. ■ umMi 



f 



Ernest Myller, M.D., Cor. Secretary 

Rudolf Virchow Medical Society 

64 East 76th Street 

New York 21, New York 



i l 



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THE RUDOLF VIRCHOW MEDICAL SOCIETY 
IN THE CITY OF NEW YORK 

THE MEDICAL CIRCLE 

THE AMERICAN SOCIETY OF 
EUROPEAN CHEMISTS AND PHARMACISTS 

request fhe pleasure of your presence at a 

SPECIAL MEETING 

in honor of the EIGHTIETH BIRTHDAY of 

PROFESSOR OTTO LOEWI 

Tuesday evening, June 2nd, 1953 
at 8 o'clock sharp 



to be held at the 

ACADEMY OF MEDICINE 

Hosack Hall 

2 East I03rd Street 

New York City 



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Fellcitations will be conveyed by 
PAUL H. HOCH 

The Rudolf Virchow Medical Society 

JOSEF NOVAK 

The Medical Circle 

HERMANN F. MARK 

The American Society of European Chennists and Pharmacists 



cuRRiER McEwen 

Dean, New York University College of Medicine 

ERNST NAVRATIL 

Professor of Gynecology, Universi+y of Graz, Austria 

McKEEN cattell 

Professor of Pharmacology, Cornell University Medical College 

Past President, The American Society for Pharmacology and 

Experimental Therapeutics 

ALEXANDER T. MARTIN 

President, New York Academy of Medicine 

HORACE W. STUNKARD 

Chairman, Department of Biology, New York University 
Past President, New York Academy of Sciences 

OTTO KRAYER 

Professor of Pharmacology, Harvard University 

ERNST P. PICK 

Clinical Professor of Pharmacology, Colunnbia University 

Formerly Professor of Pharmacology and Director of the 

Pharmacological Institute, University of Vienna 



■■»' 



mmmmmm 



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ADDRESSES 
will be dellvered by 



CHARLES H. BEST 

Professor of Physiology, University of Toronto 



CARL F. CORI 

Professor of Biological Chemistry, Washington University, St. Louis 



SEVERO OCHOA 

Professor of Pharmacology. New York University College of Medicine 

Chalrman: 
PAUL H. HOCH 




A Receptlon will be held after the Ceremonies in the 

Presidents' Gallery 
Refreshments will be served. Dress Optional. 



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RHODE ISLAND HOSPITAL 

S93 EOOY STREET, PROVIDENCE, R. I. 



Ouvix, ^rOj l<^5'i. 






Dear Doctor: 



f 



entitled 



I have read with great interest your article 

as published in N. CX. l4f .66, , ~3"u,vcc a\ ^ V C| 3 ';^ 

I shall appreciate it very much if you would 

be kind enough to forward to me ö H-d- . 

reprint/ of same. 

J) ^Cl-hJc Aji/Uf/ "7^t<j6 f-^^ ^^-^^rtCCJLß^^ ^ 

'Sincerely, 

George W. Water man, M. I>. 
Chief, Department of Gynecology 






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Doctor L C. Rubin 
911 Park Avenue 
New York 21. N.Y. 

BUtterfield 8-1980 

Jeruary 19,1955 



My dear Mrs^ Myller: 

I have had a rec^uebt frou the 
Mericen Society for the Study of Steril ity 
to v<rite an obituary notice in the Fertility 
and bterility Journal for Doctor Myller. Ifl'ould 
you be good enough to let me have a copy of the 
notice tixfit appeerec in the paper ehortly after 
his pai^sing? 

Incidentflly the enclosed is what 
I collected froni Mme. Alexis Kyrou who v/as here 
recently. Sho needs? an Operation but prefers to 
have it done in Greece where sne says it will cost 
her less. 

Best regerds to you and your son. 

Sincerely yoars, 



iVr&« Emest Myller 
450 Eaeb 63 rd Street 
New York City 




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BUtteHield 8-5929 



I 



ERNEST mVlLER, M. D. 

65 EAST 76th STREET 

New Y«*k 21, N. Y. 



FOR PROFESSIONAL SERVICES 




mmatk 



•mm* 



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Cyclo gesterine tablets. (Upjohn) 
3 tablets for 10 days 



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NEW YORK UNIVERSITY-BELLEVUE MEDICAL CENTER 

OF NEW YORK UNIVERSITY 

POST-GRADUATE MEDICAL SCHOOL 

303 HAST 20TH STREET. NEW YORK 3. N. Y. 

July 21, 1953 



DEPARTMENT OF OBSTETRICS AND GYNECOLOGY 

GOUVERNEUR HObPITAL 
621 Water Street 
NEW YORK 2, N.T. 



GRAMERCY 7-2000 



f 



Ernest Myller, M.D. 
65 E 76th Street 
New York City 

Dear Dr. Myller: 

I shall appreciate your attending V^edn^sday dftemooii st CouveiTieur 
Eosiit.-! fcr t,he present. 

I have already written conceming the matter which we discussed at the 
telephone. This is in the hands of Dr. Studdiford and I hope and believe we 
will have favorable reply shortly. 

Sinceroly yours, 

Locke L. Mackenzie, M.D. 



Dr.xM/rj 



mtummmm 



Conclusions 



Tlie importaiicc ul' ccrvifai obturation in tlie piocedure ot' iitorotubal 
iiisufiflation and liysterüsal{)ingo«»rai)hy lia« been cinphasized. Desidcrata ot' the 
ideal uterina cannula are : 

1. Paiiiless applieation uiiaccoinpanied by trainna. 

2. Airti<2jht ciosuro oi* the eervical eaiial. 

JJ. Mainteiianee of the normal anatomical position ot" the utcriis. 

A new cannula with inflatable balloon l'or cervical obtunition has beon 
desci'ibed. 

References 

1. Personal coiniiiunieHtion. Acknowledginent is lierevvitli iiiado t<» H. h. Stout, M.D., f<»r 

liis kiiidness in lettin^ us see his instrununit. 
'2. Decker, Alhort: Am. .). Obst. & Gynkc. 54: 1077, 11)47. 
;?. Kubin, I. (\: Am. .1. Obst. & Gyxkc. 45: 41'.). 1!)4:?. 



CEUVICAL OBTIIKATIOX WITIl 

INFLATABLE (^VXXFLA IN 

UTEHOTriJAL IXSrFFLATlOX 

ÄND IIYSTEKOSALPINGOGRAIMIY 

I. C. RUBIX, M.Ü., F.A.C.S. 

and 

KKXKSST MYLLEK, M.D. 

New York, N. Y. 



Heprinted from 

AMKKICA.N .FOUKNAF. OF OliSTKTHKS 

AXF) (}VXE('()I.()(JV 

St. liüuis 



Vol. 



.)<•, Xo. <i, Page« lü77-l(),s:2, I>e<-etnlM'r, 
1948 

( l'rint«'(l in the r. .S. A. i 



4 






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CERVICAL OBTURATION WITH INFLATABLE CANNULA IN 
ÜTEROTUBAL INSUFFLATION AND HYSTEROSALPINGOGRAPHY 

T. r. Rriu\,M.D., F.A.(\S., and Eknest Myij.kk, M.D., Nkw Vohk, N. V. 

CKHViCAL obturatioii is ot' major iniportaiu-e in the teehnical pi-occdurc 
of uterotubal insuftlation and hystero*?raphy. Re«j;nrgitati()n of ('(>_• iüt^; 
or oil Icads 1o unroliable estimation oi" the pressure eini)l()yed, and not inlic- 
(pieiitlv to wronjy interi)rotation as to tii})al ])ateney. ()l)turati()n is usimlly 
seeured by i)resNin«»- a r\il)ber oi* metal acorn aj^ainst llie eei'vieal os. Tbis is 
easily aeconipüshed in tlie i)resenee of a round and well-sbaped external orifiee. 
Ilovvever, il* tlie external os is irre«>ular in eontour as in hieeratioiis and eversioiis. 
exeessive |)ressure inust be exerted t)y tlie aeorn in order to prevent U'aka^c 
of the eontrast medium or of (H). «jas as the ease may be. To prevenl 
re<iur^itation the eervix inust be «^rasped tirndy with a tenaeuhun foreeps 
exertinii>' eounter ])ressure. In this maneuver, the uterus is either pushed up- 
ward Ol- dravvn down. To keep the balanee by equal push and pull is some- 
linies diftieull. The anatomie chan^re in position may oeeasionally be suffieienl 
t<» sinudale closure of the tubes by eausinji: artiticial kinks at the uterotubal 
junetion or ])v artifieallv stretchiu"; adhesions which do not otherwise obstruel 
the tubal lumen when tho normal position of the uterus is undisturl)ed. The 
cannula devised bv Colvin with sercw tips of various sizes, later modified by 
nud«»ins, affords ti«iht ohturation l)Ut involves a eertain amount of trauma 
whieh theoretically may predispose to embolization. 

After manv vears experienec with hvsterosali)in«»:o«i;rapiiy and uteiolubal 
insufflation the ])rerequisites of an ideal uterine eannula appear to be the fol- 



lowni«: 



1. Its applieation should be painless and unaeeompanied by trauma. 

2. It must provide airtight ohturation of the cervical canal. 

3. It should maintain the normal anatomical position of the uterus. 

The cannula presented in this paper has been devised with these desiderata 
in view. It is based on a rather old device, namely, the use of an intlatable 
rubber bulb in order to change the diameter of a rv/u\ instrument. Nitze, 
the inventor of the cystoscope, made use of this prineiple for a ureteral 
catheter. in 1883, a United States |)atent was «iranted to Henry E. Finney 
for an instrument based on the samo prineiple for ''the treatment of the male 
Urethra." Ahout twelve years ago, one of us (LCR.) construeted a cannula 
similar in prineiple to the one about to be described. Dr. R. B. Stout had the 
same idea, except that he placed the rubber balloon within the uterine cavity.' 
Deckel-,^ in a recent puI)lication, also recommends insertinj? the rubbei* balloon 
surrounding the cannula tip into the uterine eavity. This prineiple has been 
employed by one of us in study ing the differential between uterine and tubal 
contractions during uterotubal insufflation.^ 



3 



The present cannula (Fig. 1) has developed out of a simple model whicli 
we have used since 1946 in 175 eases for eervical obturation. The eannula has 
the Ienj»th and dianieter of an ordinary uterine sound. It consists of two 
inetal Channels, one of whieh is very narrow and ends aboiit 2 cm. hehind the 
ti}) of the Instrument. Its opening is eovered hy a thin, elastic rubber tube, 2 
lo 8 cm. long, which is tied at each end to the shaft of the instrument l)y 
snrgical silk.* 




ViK. 1.— Cannula assonibled roady for- use witli levolvin« «lisi-, hubs foi- sviin^e an«! 
inanometer connections and inflatable tip (letter B below letter C not visible), (a). Rubber 
tubing distended. (ft). Extension tip for instMtion into uterin»' ravitv. 



The instrument can be inserted easily into any eervical canal which admits 
a uterine sound. In most cases it is not necessary to grasp the cervix with 
a tenaculum forceps. The latter can be removed as soon as the rubber-covered 
tip has been inserted inside the eervical canal. In certain cases, e.g., Stenosis 
of the internal os, it niay be desirable to insert the cannula with its tip in the 
uterine cavity. For such imri)ose the short ti]) (T) (Fig. 1) may be rei)bu-e(l 
by a h)nger one (T,) (Fig. 1). Preliminary dilatation, when desn-abie, shouM 
not be done just before the injection of contrast media or before insufiHation. 
So far it has been ])ossible in our cases to introduce the cannula in eervical 
Stenosis after the latter was passed by a uterine sound. 

The cannula is inserted with the revolving disc D in the position that 
presents the engraved letter B (bulb on the disc) (Fig. 1) opposite a fixed 
uidicator. Through hub A, which fits the J.uer syringe, 1 to 3 c.c. of water oi- 
air are injected and thus the rubber tube at the end of the instrument becomes 
distended (Fig. la). With a little experience one can soon feel whether the 
bulb IS sufficiently expanded. If one is interested in checking the pressure in the 
inflated balloon, he need only turn the disc to T, remove the syringe, and attach 
a manometer to hub A. On turning the disc back to B, the pressure within the 
'•^^^^>c^' balloon will be prom])tly indicated on the numometer. It is to be noted 

i:. r.6 7treef.^Te"wVork'^?^^^^ '^ ""^^^ ^"^ clistributed by United Surgical Supply Co.. lüO 



that if less than 1 c.c. of air or water is used to inflate the balloon, the pressure 
readings in the balloon may not be accurate. \ow the disc is turned to the i)osi- 
tion marked by the letter C (elosed) and the instrument is ready for the pro- 
cedure. 




Ms^. 



■*^v*: r* -^jiu^ -rmm- 



Vig. 2.— Inflatable cannula flUed with diodrast obturatin^ the eervical canal. Note that it Ks 
pyriform or acorn in shape as compared to the oval-shaped inflated cannula outside of the body. 



The disc is now turned to the position X (== x-ray) thus eonneeting hub A 
directly wäth the tip of the instrument inside the eervical can^l, or to tip T;. 
in the uterine cavity. A Luer syringe containing the contrast medium is 
connected to hub A and the medium is injected into tiie iiterus and the x-ray 
exposure follows. For fractional injection of contrast medium, the disc is 
turned to position C after the first fraction is introduced. Ilands and syringe 
may now be removed because the expanded bulb retains the cannula in situ.* 
By turning the disc back to position X the second fractional injection can be 
made, and if need be, a third or fourth. 

When the kymograph is employed it is connected to hub A and the disc is 
turned to position X. The insufflation test can be carried out with a 20 c.c. 

•A special clatnp adaptable to any vasinal speculuin has been devised to keep the ean- 
nula in the horizontal position. 



Luer syrin<?e attached to Imb A. The diso is turned to position R (= Kubiii 
tost) whicli oiia])los us to nioasui'o tlie oxortod i)rossui'e ])y conneeting tho man- 
ometer to hui) B. In tlie siniplified test, 20 c.c. of carbon dioxide injected by 
a syriiige is sufficicnt beeause of thc coniplete elosure ot" the cervix without aiiy 
leakago. A suddon fall of inaiionictrio pressure is indieative of tubal pateney. 
If Shoulder pains result they are minimal.* 

By inflating the rubber bulb with an a(|ueous contrast medium (e.«»;. 
diodrast) one eaii easily demoustrate the relation of the bulb to the cervieal 
canal (Fig. 2). In order to notc the distensibility of the intracervieal balloon 
and any changes that the eervieal walls might exert upon it, another cannula 
with the balloon filled with an ecpial amoiuit of diodrast was exposed at the 
same time on the same x-ray film, The shape of the balloon inside the cervix 
may be eompared to the external ballocm in Fig. 2. In Fig. 3, water has re- 
placed the diodrast and is therefore invisible, while the uterine cavity is 
Seen filled with contrast medium. Ineidentally, the cervieal balloon reveals a 
configuration whicli does not couforiii to what one notes in conventional draw- 
ings of the cervieal canal beeause of distention by the rubber balloon. The 
cervieal canal appears, from our study, to yield readily to a greater degree of 
dilatation than has hitherto been realizcd.f 

Owing to rigid walls, some cervices were found to resist balloon distention 
with 2 to 3 c.c. of water. Nevertheless, good olituration could be obtained with 
less filling. If the rubber ])art of the insti'ument is not iuserted deep enough 
into the cervieal canal the balloon may liulge Ihi'ough the extei-nal os. IIow- 
ever, this does not prevent airtight elosure. Sliould the rubber bulb be pushed 
out entirely from the cervix it mav be reiuserted and kei)t in place by grasi)ing 
the anterior lip of the cervix with a tenaculum forceps. In several cases the 
cervix was found transformed into a shallow cone. Airtight elosure could 
be obtained in these cases by advaucing the ex])anded rubber bulb into the 
cone while the cervix was held in ])lace })y a tenaculum force]is. 

The present caninila has the advantage over the ordinary cannula with an 
acorn tip in that it brings a lai-ger area of the endocervix in contact with 
the acorn. Jlence, the pressure recpiired to obturate the cervix is less. As 
this pressuie is not only directed upwai'd, bul upon all sides, dislocation of the 
cervix does not as a rule result. 

The pressure within the rubber balloon automaticallv predetermines the 
maximum pressure which is intended to be used for the insufflation test or 
salpingography. If, for example in the bulb is 250 mm. Hg and the pressure 
used during insufflation or sali)ingography is higher, no matter how little this 
may be, there is prompt esca])e of the gas, or oil from the cervix. The same 
physical law operates here as in measuring blood ])ressure. If the blood pressure 
exceeds the pressure in the armcuff, tlie i)ulse wave immediately returns. 
The balloon in the present cannula thus forms a desirable safety valve which 
automatically prevents an undue increase of pressure inside tlie uterus. 

This feature of the instrument is of importance for salpingography. 
Usually a contrast medium is used wbich has a certain viscosity. "^ Pressure 
determinations when lii)iodol or other viscous fluid is used are iiot accurate 
beeause of the considerable friction inside the small lumen of the cannula 
where a rapid decrease of i)i'essure takes ])lace with each progressive centimeter 
of the lumen. When the constrast medium enters the uterine cavitv the 



JV^^*l ^^^}°^ author dpes not recommend or employ the use of the syringe for inject 



inpT 



CJOz into the Uterus for testing tubal pateney, pref erring insufflation by means of the aut'omatiV 
Siphon Mieter with kyn.ograph. The ptisc-nt cannula is adniirably adapted for this apparatis 

future^ public^a°tk)n.''*' *'^^'''*'*'"^' °^ *^^ ^^^"'^'^ »"^*^'' various condltions will be the ba.sls of a 



pressure hievitably falls. If tuhal ohstruction is encountered there is a gradual 
increase of pressure inside the uterus until it equals that which is exerted by 
the syringe. Before this point is reached a high j)ressure may be exerted 
through the syringe which is not usually appreciated by the Operator unless 
he uses a manometer. The rubber balloon afVoids safety beeause when the 
pressure exceeds that within the bulb, the oil ('S('a|)es k (mce through the 
external cervieal os. 




Fig. 3. — Inflatable cannula filled with water (therefore invisible by x-ray) obturating 
tho cervieal canal. The contrast medium (rayopaque) demonstrates the uterine cavity. The 
rubber balloon distended by diodrast is seen below outside of the body for purpose of comparison. 



The Instrument can be sterilized by boiling. The rubber bulb can stand 
boiling many times; its cost, however, is so small that it may readily be replaced 
for each test, We have found it practical to fiU the })ulb before inserting the 
cannula in order to note whether it is watertight. However, should the 
rubber break it is immediately a])preciated by the drop in resistance. The 
water escapes through the external os and does no harni. It is particularly to 
be noted that the Operation of the cannula is exceedingly simple, and after some 
little experience, requires a minimum of time. 



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BULLETIN 

of 

THE AMERICAN BOARD 

of 

OBSTETRICS AND 
GYNECOLOGY 



/ AGS ^„ 
AAOG&AS 
k AMA / 



ElGHTEENTH ISSUE 

June, 1947 



OFFICE: 

1015 Highland Building 

PnrsBURGH (6), Pa. 



PAUL TITUS, M.D., Secretary 



The American Board 

of 

Obstetrics and Gynecology, Inc. 



DIRECTORS 
President 
Walter T. Dannreuther. M.D., New York CSity 
A. A. O. G. and A. S. 

Vice'President 

Joseph L. Baer, M.D., Chicago, Illinois 

A. G. S. 

Vice'President 
Ludwig A. Emge, M.D., San Francisco, Calif. 
Section on O. and G.. A. M. A. 

SecretaryTreasurer 
Paul Titus. M.D.. Pittsburgh, Pennsylvania 
A. A. O. G. and A. S. 

Memher Executive Committee 

Norman F. Miller, M.D., Ann Arbor, Mich. 

Section on O. and G., A. M. A. 

Edward A. Schumann, M.D., Philadelphia, Pa. 

Norman F. Miller. MD., Ann Arbor, Michigan 

A. G. S. 

' Willard R. Cooke. M.D., Galveston, Texas 
A. A. O. G. and A. S. 

F. Bayard Carter. M.D., Durham, N. C. 
Section on O. tf G., A. M. A. 

Robert L. Faulkner, M.D., Cleveland. Ohio 

A. G. S. 



Reed B. Dawson, Esq., New York City 

Counsel 



Former Directors of the Board 

F. L. Adair, M.D., Chicago, 111. 

E. D. Plass, M.D., Iowa City, Iowa. 

G. D. Royston, M.D., St. Louis, Mo. 

J. C. Litzenberg, M.D., Minneapolis, Minn. 
R. D. Mussey, M.D., Rochester, Minn. 
E. A. Schumann, M.D., Philadelphia, Pa. 
Norris W. Vaux, M.D., Philadelphia, Pa. 
L. E. Phaneuf, M.D., Boston, Mass. 



Associate Examiners Who Have Served 
With the Board 

W. T. Black, M.D., Memphis, Tenn. (Dcceased) 

L. A. Calkins, M.D., Kansas City, Mo. 

S. A. Chalfant, M.D., Pittsburgh, Pa. (Dcceascd) 

C. G. Collins, M.D., New Orleans, La. 

S. A. Cosgrove, M.D., Jersey City, N. J. 

W. C. Danforth, M.D., Evanston, 111. 

W. J. Dieckmann, M.D., Chicago, 111. 

N. J. Eastman, M.D., Baltimore, Md. 

J. R. Eisaman, M.D., Pittsburgh, Pa. 

Frederick H. Falls, MD., Chicago, 111. 

R. L. Faulkner, MD., Cleveland, Ohio. 

J. W. Harris, M.D., Madison, Wis. 

W. P. Healy, MD., New York Qty. 

H. Close Hesseltine, M.D., Chicago, 111. 

James E. King, M.D., Buffalo, N. Y. (Deccased) 

C. B. Lull, M.D., Philadelphia, Pa. 

Harvey B. Matthews, M.D., Brooklyn, N. Y. 

James R. McCord, M.D., Atlanta, Ga. 

L. G. McNeile, M.D., Los Angeles, Calif. (Deceased) 

Emil Novak, M.D., Baltimore, Md. 

John L. Parks, M.D., Washington, D. C. 

W. T. Pride, M.D., Memphis, Tenn. 

L. M. Randall, M.D., Rochester, Minn. 

G. D. Royston, M.D., St. Louis, Mo. 

H. E. Schmitz, M.D., Chicago, 111. 

Otto H. Schwarz, M.D., St. Louis, Mo. 

Ward F. Seeley, M.D., Detroit, Mich. 

N. W. Vaux, M.D., Philadelphia, Pa. 

W. H. Vogt, M.D., St Louis, Mo. (Dcceascd) 

W. H. Weir, M.D., Cleveland, Ohio. 



THE AMERICAN BOARD OF 
OBSTETRICS AND GYNECOLOGY 



ORGANIZATION 

In 1930 the American Asscx:iation of Obstetri' 
cians, Gynecologists, and Abdominal Surgeons, 
the American Gynecological Society, and the See 
tion on Obstetrics and Gynecology of the Amef 
ican Medical Association, each elected three Fei' 
lows to constitute the American Board of Obstet' 
rics and Gynecology. 

Dr. Walter T. Dannreuther of New York, Dr. 
Paul Titus of Pittsburgh, and Dr. Grandison D. 
Royston of St. Louis were appointed to represent 
the American Association of Obstetricians, Gyne' 
cologists, and Abdominal Surgeons; Dr. Jennings 
C. Lit2;enberg of MinneapoHs, Dr. Joseph L. Baer 
of Chicago, and Dr. E. A. Schumann of Phila' 
delphia were appointed to represent the Ameri' 
can Gynecological Society; Dr. Fred L. Adair of 
Chicago, Dr. R. D. Mussey of Rochester, Minn., 
and Dr. E. D. Plass of Iowa City, Iowa, were 
appointed to represent the Section on Obstetrics, 
Gynecology, and Abdominal Syrgery of the 
American Medical Association. Since formation 
of the Board several of the original members have 
resigned and others have been duly appointed to 
fiU their places. 

The Board was incorporated, organized and held 
its first meeting in September 1930. At that time 
the ByLaws were adopted and provisions were 
made by resolutions for its proper functioning. 

This Board had been in the process of organiza' 
tion since 1927 and put into action a determ/ned 
effort on the part of these three national organi« 
zations to improve the Standards of practice of 
obstetrics and gynecology. 

PURPOSES OF THE BOARD 

First: To elevate the Standards and advance the 
cause of obstetrics and gynecology. 

Second: To determine the competence of prac 
titioners professing to be specialists in obstetrics 
and gynecology. 



Third: To arrange, control, and conduct exam' 
inations to test the qualifications of voluntary 
candidates appearing before the Board for certi' 
fication as specialists in obstetrics and gynecology. 

Fourth : To grant and issue certificates of quali' 
fication as specialists in the field of obstetrics and 
gynecology to candidates successful in demon' 
strating their proficiency. 

Fifth: To serve the public, hospitals and the 
medical schools by preparing lists of speciaHsts 
certified by the Board. 

These activities proceed from the certificate of in' 
Corporation in which it is stated that "the natura 
of the business and the objects or purposes prcK 
posed to be transacted, promoted and carried on 
by it" are as follows: 

"To encourage the study, improve 
the practice, and advance the cause 
of obstetrics and gynecology, sub' 
jects which should be inseparably 
interwoven; and to grant and to 
issue to physicians duly licensed by 
law, certificates or other equivalent 
recognition of special knowledge in 
obstetrics and gynecology." 

VALUE OF CERTIFICATES 

The national obstetrical and gynecological or' 
ganizations, which have participated in the for' 
mation of the Board and are Sponsoring its activi' 
ties, as well as other societies, attach considerable 
importance to its certificate. Both the medical and 
the lay public, including hospital directors, have 
come to utilize the certificate from this Board 
freely as a means of determining who are well 
grounded as speciaHsts in obstetrics and gync 
cology. 

Lists of those holding certificates from this Board 
and limiting their practice to obstetrics and 
gynecology are published in the Directory of 
Medical Specialists; similar lists are published by 
the American Journal of Obstetrics and Gync 
cology, and also appear in the American Medical 
Directory. This latter indicates Diplomates of this 
and other Boards by means of numerical Symbols 



dppearing in the Biographie records, but does not 
gi\e such special recognition to Diplomates who 
are not members of the American Medical Asso' 
ciation. 

Each certificate granted or issued does not of it' 
seif confer or purport to confer upon any per' 
son any degree or legal qualifications, privileges or 
license to practice obstetrics or gynecology, nor 
does the Board intend in any way to interfere 
with or limit the professional activities of any 
duly licensed physician. Its chief aim is to stand' 
ardize qualification for specialists in obstetrics and 
gynecology, and to certify as specialists those who 
voluntarily appear before the Board for such rec' 
ognition and certification, according to its reguk' 
tions and requirements. 

This Board does not subscribe to any hospital rule 
that certification is to be required for medical 
appointments especially in ranks lower than Chief 
or Senior Staff of hospitals, or Associate Profes' 
sorship in Schools of Medicine, for the obvious 
reason that such appointments constitute desirable 
specialist training. 

Even though certification or its füll equivalent 
may be considered a desirable requisite to appoint' 
ment in key positions, as on the Senior or Chief 
Staff, particularly of hospitals expecting to con' 
duct approved Services for training of residents, 
it was never intended by this Board that certifica' 
tion should be required by any hospital as a pre' 
requisite to appointment, especially in such lesser 
positions. 

REVOCATION OF CERTIFICATES 

Each Certificate of Qualification may be revoked 
by this Board in the event that: 

1. Any representation or Statement made 
to the Board or to any of its representatives 
by the physician so certified, including the 
Statements contained in his application for 
certification, shall have been false or inten' 
tionally misleading. 

2. The physician so certified shall not in 
fact have been eligible to receive certifica' 
tion, irrespective of whether or not the facts 
constituting such ineHgibility were known to 






or could have been ascertained by this Board, 
its members, directors, examiners, officers or 
agents at or before the time of issuance of 
such Certificate of Qualification. 

3. Any rule governing examination for 
certification shall have been violated by the 
physician so certified and the fact of such 
violation shall not have been ascertained 
until after the issuance of the Certificate of 
Qualification. 

4. The physician so certified shall fail to 
abide by the regulations governing the limi' 
tation of his practice to the specialty of 
obstetrics and gynecology. 

5. The physician so certified shall violate 
the Standards of ethical practice of medicine 
then accepted by organized medicine in the 
locality in which he shall be practicing, and, 
without limitation of the foregoing, the for' 
feiture, revocation or Suspension of his li' 
cense to practice medicine, or the expulsion 
from, or Suspension from the rights and priv 
ileges of membership in, the American Med' 
icaä Association or any State or county so' 
ciety affiliated therewith, any recognized 
Canadian medical society, the American As' 
sociation of Obstetricians, Gynecologists 
and Abdominal Surgeons or the American 
Gynecological Society shall be conclusive evi' 
dence of a violation of such Standards of 
ethical practice of medicine. 

6. The physician so certified shall fail to 
comply with or violate, or the issuance or 
receipt by him of such Certificate of QuaH' 
fication shall have been contrary to or in 
violation of , the Certificate of Incorporation, 
the By-Laws or the Rules and Regulations of 
this Board. 

Upon revocation of any Certificate of QuaHfica' 
tion by this Board as aforesaid, the holder therc' 
of shall retum his Certificate of Qualification and 
all other evidence of certification to the Secretary 
of the Board and his name shall be removed from 
the list of Certificate holders of this Board. 



PREREQUISITES TO ELIGIBILITY 

Each applicant before he may become eligible to 
receive such certificate or other evidence of recog' 
nition : 

1. Must have had conferred upon him a 
degree in medicine by an Institution of learn- 
ing approved by the Advisory Board for 
Medical Specialties and the Council on Med' 
ical Education and Hospitals of the Amer' 
ican Medical Association. 

2. Must establish in a manner satisfactory 
to the Board of Directors th'at he is a physi' 
cian duly Hcensed to practice medicine, and 

(a) That he is of high ethical and 
professional Standing. 

(b) That he has received adequate 
training in both obstetrics and gynecol' 
ogy as a specialty. Training in one 
branch only is not acceptable. 

3. Must make application for investigation 
of his credentials and a survey of his char' 
acter. 

4. Must assure the Board that he is limit' 
ing his practice to obstetrics and/or gyne' 
cology and that he intends to continue to 
do so, except for military duties, having 
limited for at least six (6) months before 
making application (except for active mili' 
tary duty). 

5. Must have membership in the American 
Medical Association, or membership in such 
Canadian or other medical societies as are 
recognized for this purpose by the Council 
on Medical Education and Hospitals of the 
American Medical Association. (Membership 
in the AMA or equivalent society member' 
ship is waived, temporarily, for men in the 
Army or Navy, especially for those who 
proceeded directly or almost so from hospital 
Services into Army or Navy Services, upon 
a Statement of intention to join promptly 
upon retum to civilian practice.) 

6. This Board will not accept appli' 
cants for examination who are not füll citi' 

8 



zens of the United States or of Canada, 
though they be residents of either country. 
Foreign born applicants must have been cer' 
tified by either the National Board of Medi' 
cal Examiners or licensed to practice medi' 
eine in the United States or Canada by a 
State or Provincial Board of Licensure. 
Notarized Statements, not original Citizen' 
ship papers, must be fumished when the ap' 
plication is filed attesting to the fact of füll 
citizenship in the United States or Canada, 
if the applicant is foreign born. Further, 
there will be required a probationary period 
of at least three (3) years from the date of 
licensure in the practice of medicine in these 
countries before such a candidate may be 
admitted to examination. 

7. The Board accepts the fifth or "intern" 
medical school year required at some schools 
in lieu of the usual fifth or intern "clinical 
training" year following graduation. As a 
Substitute for special training, service with 
a qualified obstetrician'gynecologist precep' 
tor, preferably one who has been certified by 
the Board, may be acceptable. The exact time 
basis for this has not been specified, and 
each case must be reviewed and decided in' 
dividually by the Credentials Committee 
after the application is submitted in the 
regulär manner. The time allowance for this 
type of training will vary with the amount 
of work done with the preceptor. Opportun' 
ity for personal responsibility during this 
period of training is essential. 

8. The Board conformed with the gen' 
eral acceleration in programs in medical edu' 
cation in that it will accept a period of nine 
"accelerated" months as an academic year in 
satisfying our requirement for each of three 
years of residency training. Such allowances 
can be made only for Services during the 
wartime period of the official "accelerated 
program" and are not made for Services bc 
fore 1944 or after the discontinuance of this 
acceleration in 1946. 

9. The period of special training should 
emphasize the relation of the basic sciences, 



anatomy, pathology, physiology, biochemis' 
try, and bacteriology, to the application of 
surgical principles which are fundamental in 
all branches of surgery. In addition, the can' 
didate must understand and be trained in the 
following subjects, viz., the care of emer' 
gencies, shock, hemorrhage, blood replacc 
ment, electrolyte and fluid balance, protein 
and nitrogen balance, choice of anesthetics, 
chemotherapy, acidosis, and alkalosis, narco' 
tics and hypnotics, wound healing, etc. 

10. Credit for graduate courses in the basic 
Sciences which involve laboratory and didac 
tic teaching rather than clinical experience 
or opportunities will be given credit for the 
time spent up to a maximum period of not 
more than six months regardless of the dura' 
tion of the course. 

11. An acceptable residency is one which 
has been approved by the Council on Medi' 
cal Education and Hospitals of the American 
Medical Association jointly with this Board. 

12. The Board has ruled that physicians 
who accept male patients in their private or 
other practice, for operative or other care, 
cannot be regarded as specialists in obstetrics 
and gynecology, except by special ruling 
when this is related to active military duty. 

13. This Board deprecates engagement in 
fields of practice other than that in which 
candidates profess to be specialists. The 
Board does not exclude from examination, 
however, obstetricians and/or gynecologists 
who practice abdominal surgery and urology 
in the female, as well as breast surgery, be' 
cause of the correlation of these activities. 

Military Service or any other similar patriotic 
Service, such as work with Selective Service 
Boards, etc., have not been construed as nou' 
limitation of practice in violation of the 
Board regulätions. 

REQUIREMENTS 

The requirements for all candidates will be uni' 
form as foUows: 

1. Completion of at least one (1) year 

10 



intern service in a hospital approved by 
the Council on Medical Education and HoS' 
pitals of the A. M. A. (This need not be a 
general rotating internship, although this 
latter is preferred.) 

(A second year general internship is to be 
considered as one of a candidate's years of 
practice. No credit will be given toward spe' 
cial training during a second year general 
internship.) 

2. A minimum of scven (7) years of prac 
tice after the intern year, including at least 
three (3) years of residency training in ap' 
proved institutions, or adequate preceptor' 
ship training as a formal assistant, prefer' 
ably füll time, in approved institutions or 
with recognized specialists in obstetrics and/ 
or gynecology satisfactory to the Board of 
Directors. 

This Board, in Cooperation with the Council 
on Medical Education and Hospitals of the 
American Medical Association, surveys in' 
stitutions providing acceptable residencies in 
obstetrics and gynecology. 

The American Board of Obstetrics and Gync 
cology establishes herewith requirements for 
its approval of a residency in a hospital de' 
partment or service : 

1. The Chief of the Active Visiting Staff of 
the Department must be certified by this 
Board with at least one other of his subordi' 
nates, the remaining members of the Staff 
must be otherwise acceptably qualified to 
teach and to practice obstetrics-gynecology. 

2. In instances where the Services of obstet' 
rics'gynecology are not combined but are 
separate in any given hospital, the Chief of 
each such service and at least one of his sub' 
ordinates must be certified. 

3. If obstetrics and gynecology are not com' 
bined in one department, approval can be 
granted only if arrangements are made for 
some degree of rotation of residents between 
both Services. 

4. If gynecology is classified in the given 
hospital as a subdivision or subservice of 

11 



surgery, approval cannot be granted for resi' 
dency training in gynecx)logy. 

5. Exceptions to the foregoing, in respect 
to the certified Status of Chiefs of Service 
and others as outHned above, can be made 
only by unanimous assent of the Committee 
on Postgraduale Survey, for adequate and 
justifiable reasons. As examples of the latter, 
the degree of F.A.C.S. in obstetrics'gync 
cology might be accepted in Heu of one of 
the two required certifications if the general 
reputation of the person concerned is known 
to the Committee as national or sectional in 
scope, or a professorial rank without certifi' 
cation might be acceptable. 

6. It should be recalled by all concerned 
that credits for graduate training may be ob' 
tai nable for residency or assistantship service 
in hospitals not ofEcially approved for resi- 
dency training. Each such case must be indi' 
vidually considered, and credits will be largc 
ly dependent upon the teaching qualifications 
of those in charge of the service, and the clin' 
ical facilities of the hospital in question. 

Lists of formally approved institutions for 
special residency training appear regularly 
in certain issues of the Journal of the A. 
M. A. Detailed information about any of 
these can be obtained by applying to the 
A. M. A. 

It is possible for candidates trained in some 
unclassified or as yet unapproved hospitals 
to obtain credit for this training if properly 
supervised. Each such case must be consid' 
ered on its own merits. 

Candidates should ofFer as Sponsors or refer' 
ences, two Diplomates of this Board with 
whom they are presently in contact, rather 
than men under whom they served as resi' 
dents only. 

APPLICATION AND FEES 

Application must be made on a special blank 
which will be furnished by the Secretary's Office, 
1015 Highland Building, Pittsburgh (6), Pa., and 
must be forwarded with the other required crc 
dentials and the application fee to the Secre' 

12 



; . 



tary's Office at least ninety (90) days prior to 
the scheduled date of the examinations. 

Application fee « $ 1 5 .00 

Make checks payable to American Board of 

Obstetrics and Gynecology, Not returnable. 
(Applications will not be considered for 
Classification and action by the Credentials 
Committee unless accompanied by the appli' 
cation fee.) 

Examination fee _ $85.00 

(Payable when the candidate is notified of 
acceptance for examination. Not returnable 
after the candidate has been officially ac 
cepted by the Credentials Committee and 
notified to report for examination.) 

Total fee $100.00 

The fees have been carefully computed on a 
basis of cost of examinations and are used en' 
tirely for administrative expenses. Examiners 
serve without compensation other than actual 
expenses. 

Many prospectve candidates write the Secretary's 
O&ce outlining in their letters their training quali' 
fications and asking informally if they are eligible. 
Any candidate should be able to make a fair 
estimate of his eligibility after studying this Bul' 
letin. 

The Secretary cannot and will not make any 
eligibility rulings. These are made only by the 
Credentials Committee after reviewing those ap' 
plications only, which are made on the special 
form provided for this purpose, and submitted 
to the Secretary with the candidate's applica* 
tion fee. 

All candidates must comply with Board regula' 
tions in eflFect for the year in which the exam' 
ination is taken, regardless of when the original 
application was filed. 

Applicants declared ineligible for admission to 
examination may reopen their applications within 
two (2) years of the filing date without payment 
of an additional application fee. 

Applicants declared eligible but who fail to exer' 
eise the examination privilege within three (3) 
years of the date of filing the application are re' 

11 



quired to file a new application and to pay a new 
application fee. 

An applicant in military Service during the war' 
time national emergency and assigned to work in 
general surgery under conditions acceptable to the 
Credentials Committee may receive credit up to 
a maximum of six (6) months applicable toward 
his three (3) required years of specialty training. 
The additional time may be applied toward the 
years of practice requirement. 

An applicant servmg under military Orders in an 
Army or a Navy hospital in an obstetrical and/or 
gynecological Service under supervision will be 
given the same credit as if he were working under 
a preceptor, since most of these departments are 
supervised by men who are Diplomates of this 
Board or who are recognized obstetrician'gync 
cologists. He may obtain füll residency credit if 
such hospital is ofiicially approved and listed for 
residency training in this specialty. 

Additional time in military service with any type 
of general medical assignment may be applied 
toward the Board's years of practice requirement. 
The Credentials Committee of the Board will rc 
view and give consideration to each individual 

Upon notice of acceptance for admission to 
examination, examination fee is due and also case 
records which should be shipped by the candidate 
to the Secretary's Office as soon as possible and 
not later than the date of the Part I written 
examination. 

The candidate should make immediate acknowl' 
edgment of his notice of acceptance at which 
time he will notify the Secretary's Office approxi' 
mately when to expect his case reports. 

EXAMINATIONS 

Part I examinations are scheduled annually for 
the first Friday in February. Grades cannot 
usually be mailed from the Secretary's Office un' 
til after April first following the examination. 
Arrangements will be made for candidates to 
report in any convenient city where there may 
be a Diplomate of this Board to conduct or to 
supervise the written examination which will be 

14 



sent out from the Board's Office under sealed 
Cover. 

Special arrangement will be made through senior 
officers for conducting the written portion of the 
Part I examination for men in military service. 
Such candidates are requested to keep the Secre' 
tary's Office informed at all times of changes in 
their mailing addresses. 

All applicants accepted for examination will be 
required to obtain a passing grade in both the 
written examination and a review of case reports 
(Part I), before becoming eligible for the oral' 
clinical and pathology examinations (Part II). 
The passing grade for the written examination 
and case reports is 75 per cent. A candidate 
whose grade in either or both falls below 75 per 
cent is conditioned. 

Re-examination for the removal of conditions in 
Part I may be taken after one year but within 
three years after the first failure, without pay 
ment of an additional fee. 

Candidates who successfully complete the Part 

I examination proceed automatically to the Part 

II examination held later in the year. 

Candidates appearing for rcexamination under 
a new application after two previous failures will 
not be required, if they have passed all or part 
of the Part I examinations on their first applica' 
tion, to repeat such examination items already 
successfully cleared. 

After two ineligibility or postponement rulings 
on any candidate's application, an entirely new 
application form must be submitted (with or 
without fee, according to current requirements) 
in Order to bring data down to date. The essen' 
tial feature of this should be evidence of addi' 
tional training and experience. 

All original Group A candidates, who have al' 
lowed three years or more to elapse without tak' 
ing examinations, and who care to apply again, 
must do so on the regulär current basis. If ac' 
cepted, they will now be subject to Part I and 
Part II examinations. 

Former Group A candidates appearing for rc 
examination after first failure in Part II are not 
required to take the Part I examination. 

If 



Part I 

Examination consists of : 

1. A comprehensive written examination, 
conducted annually, including questions on 
both obstetrics and gynecology and related 
basic Sciences. 

2. The filing of twentyfive (25) obstetrical 
and gynecological case reports, in Condensed 
form. Five (5) cases may concern major ill' 
nesses, not necessarily operative. These must 
be cases for which the candidate was per' 
sonally responsible. 

3. The written examination will be limited 
to a maximum period of three hours. 

(For details regarding Case Reports see next 
page) . 

Part II 

The oral'clinical and pathology examinations 
given all candidates are conducted by the entire 
Board and the Associate Examiners usually near 
the time and place of the annual meeting of 
one or more of the national societies represented 
on this Board, usually that of the American Medi' 
cal Association. Advance announcements of ex' 
amination dates and place will be made in med' 
ical Journals throughout the country. 

Examination consists of : 

1. Oral examination before two to four ex- 
aminers. 

An endeavor is made to adapt the details of 
the oral examination to each candidate's ex' 
perience and practice. The examination is 
particularly directed to ascertain his famil' 
iarity with recent obstetrical and gynecologi' 
cal literature, the related basic sciences, the 
breadth of his clinical experience, and his 
general qualifications as a specialist in obstet' 
rics and gynecology. 

2. Pathology examination. 

The candidate is expected to identify and to 
discuss several obstetrical and gynecological 
pathologic specimens and sections. 

Examiners report orally upon each candidate to 
the assembled Board, after which the results of 
their investigations are considered jointly by the 

16 



11» 



entire Board and Associate Examiners. After a 
general consideration of the details of the candi' 
date's oral and pathology examinations, including 
a review of his capability and general adaptabil' 
ity, the candidate is passed or failed by the entire 
Board. 

The final action of the Board is based upon the 
candidate's ethical and professional record, train' 
ing and attainments, as well as on the results of 
his formal examination. 

No conditions are given in Part II of the 
examination. When a candidate fails in Part II of 
the examination, he is not required to repeat 
Part I, but to take a re-examination in the oral' 
clinical and pathology portions only. One re-ex' 
amination may be taken within three (3) yearsof 
the original examination or first failure without 
reapphcation or payment of an additional fee. 

The candidate may reappear at the examination 
following the one failed by him. In applying for 
reappearance he should outline additional train' 
ing or experience acquired in the interim. The 
Board may, at its discretion, deny the candidate 
the privilege of rcexamination. 

Failure to exercise the privilege of rcexamination 
within three (3) years, entails the filing of a 
new application with the usual application and 
examination fees. 

After two failures in either Part I or Part II on 
the first application, the candidate may reapply 
and be readmitted to examinations once only. 
Exceptions to this ruling can be made only by ac 
tion of the entire Board in annual Session, usually 
to be based upon evidence of additional training 
and experience sufficient to Warrant such action. 

CASE REPORTS 

Case reports are to be sent by the candidate to 
the Secretary as soon as possible after receiving 
notification of eligibility, and not later than the 
date of the Part I written examination. 

Twentyfive (25) important obstetrical and gyne' 
cological case reports, in Condensed form, are 
required. Five (5) cases may concern major ill' 
nesses, not necessarily operative. These reports 
must include a variety of material rather than a 

17 



number of cases of one type and must be cases 
treated within four (4) years of the date of the 
candidate's application. The number of cases from 
one's residency Service should not be more than 
half the total number. 

These reports are not to be copied verbatim 
from hospital records, but must be sufficiently 
complete so that the Examiners can evaluate the 
judgment of the candidate in bis choice of 
procedure. 

Candidate should indicate on each case record 
whether this is from his residency Service or from 
his private practice and all records failing to have 
this information will be considered unacceptable. 

These reports should be prepared in Condensed 
form in Une with the foUowing items: 

1. Heading each separate case report must 
be the hospital number and date, name 
of the hospital at which the patient was 
operated, with all pertinent dates, together 
with the candidate's name or identifiable in' 
itials, name of each patient, name of oper' 
ator (candidate). The case reports should 
be given sequence numbers from 1 to 25 and 
must specify whether from residency service 
or from private practice. 

2. (a) Preoperative diagnosis and basis for 
this, in brief . 

(b) Postoperative diagnosis, based on 
findings. 

3. Nature of Operation, omitting descrip' 
tive technical details, but including pathol' 
ogist's findings on tissue removed. 

4. Critical summary or analysis of each 
case, with critical deductions derived from 
correctness or incorrectness of diagnosis, op' 
erative findings, postoperative course, and 
from final results on discharge from hospital 
and at six months ''followup" examination. 

5. Histories must be typewritten on stand' 
ard size paper, Sj/z x 11 inches, and must 
be assembled by individual cases. 

6. Reports must not be bound with any 
form of binding other than light weight 
paper folders or covers. 

18 



* 



* 



7. Two (2) separate verified index lists of 
case reports must be made for each indi' 
vidual hospital at which Operations were per' 
formed. AU verifications must be formally 
signed by the responsible hospital official, 
attesting in each instance that the candidate 
was the Operator and must State: 

Sequence numbers of case reports. 
Candidate's name at head of each page. 
Name and address of hospital. 
Whether from residency service or from 

private practice. 
Patients' names or identifiable initials. 
Patients' admission numbers. 
Date of each patient's admission. 
Date of each patient's Operation. 
Date of each patient's discharge. 

The critical summary or analysis which must bc 
prepared for each case must include: 

1. An account of the candidate's personal 
observations of the case both prior to and 
subsequent to Operation. 

2. The basis for the diagnosis. 

3. The facts that determined the course of 
treatment. Details of operative technic should 
not be included. 

4. Critical conclusions to be drawn from 
the outcome of the case. 

Case reports which do not include such discus* 
sion and comments will not be reviewed or 
graded by the Examiners. 

Obstetrical case reports should show: 

(a) Date of first prenatal visit and any 
special features bearing on the case. 

(b) The weight and condition of the child 
at birth and at time of discharge from the 
hospital. 

Obstetrical reports which do not include pelvic 

measurements either by calipers and, as indi' 

cated, by X'ray pelvimetry, will be considered 
incompletc. 

For lists of certificate holders of this, as othcr 

19 



Boards, consult the Directory of Medical Speci' 
alists Certified by American Boards (1946). 

Communications should be addressed to the Secrctary: 

DR. PAUL TITUS 
1015 Highland Building, Pittsburgh (6), Pa. 

Make checks payable to the American Board of 
Obstetrics and Gynecology. 



ADVISORY BOARD FOR MEDICAL 
SPECIALTIES 

Organized in 1933'34 to coordinate graduate education 
and certification of medical specialists in the United 
States and Canada. 

This Board holds active membersbip in the 
Advisory Board for Medical Specialists and re' 
ports directly to its member groups and functions 
in close Cooperation with the Council on Medical 
Education and Hospitals of the American Medi' 
cal Assodation. 

ÜFFICERS AND EXECUTIVE COMMITTEE 

RoBiN C. BuERKi, M.D., President 
Philadelphia, Pa. 

L. R. Chandler, M.D., Vice President 
San Francisco, CaHf. 

B. R. KiRKLiN, M.D., Secretary-Treasurer 
Rochester, Minn. 



Victor Johnson, M.D. 
Chicago, 111. 



Conrad Berens, M.D. 
New York, N. Y. 



I 



20 



Member Organizations 

The Association of American Medical Colleobs 

The American Hospital Assgoation 

The Federation of State Medical Boards 
OF the U. S. A. 

The National Board of Medical Examiners 

The American Board of Ophthalmology 

The American Board of Otolaryngology 

The American Board of Obstetrics and 
Gynecology 

The American Board of Dermatology 
and Syphilology 

The American Board of Pediatrics 

The American Board of Psychiatry and 
Neurology 

The American Board of Radiology 

The American Board of Orthopaedic Surgery 

The American Board of Urology 

The American Board of Internal Medicine 

The American Board of Pathology 

The American Board of Surgery 

The American Board of Neurological Surgery 

The American Board of Anesthesiology 

The American Board of Plastic Surgery 

The American Board of Physical Medicine 



DIRECTORY OF MEDICAL SPECIALISTS 

Publication Office 

210 East Ohio Street, Chicago, 11, Illinois 



The Joint Directory of Medical Specialists certified by 
the fiftcen special Boards was first published in 1940 by 
the Advisory Board for Medical Specialties; a second 
edition appeared in February, 1942; and a third edition 
in 1946. The third edition of the Directory referred to 
above is published by the A. N. Marquis Company, 
210 East Ohio Street, Chicago, 11, Illinois. List price 
is $10.30. Between editions frequent Bulletins are to bc 
issued to Directory subscribers, listing new names as 
thcy are certified up to the time of issuance of the 
succeeding Directory. 

21 



n 



i 






25 years ago Rubin a4troduced a nethod 



• • • •• 



With noinal patency the -^aspressure rises 
to 70rnm and falls to ^0 mm, Conf irmation 
by Shoulder pain, Refewed pain* 

Indication. it sho'.a.d be the first test aftei 
the husjands Genen h:is been exair.inned. 

Contra indlcations; " ELeeding 

Purulent discharge 
Recent infla^iiriations 

Large timiors 

Sermons cardiac disease 

Bleeding on incertion o: 

cannula 
Pregnancy 

Apparatiis used. 

Garbondioxyd super ior to air, 
Deccription of apparatus 
Use of s^nringe 
CaniiUlas, 

Time for test# 

Eadonetriuin has least thichness 

no dnnger of endoi.ietriosis 

no interf erence with pregnancy 

The test: 

Testing of apparatus 
Placing od patient 
Decinfection 
Edrection of canal 

exar-ination 

sounding, better not 

Stenosis of internal os 

Don^t dilate 

Cervix: 

Insertion ^d.th pressure 
Graspinf of cervix 
nislocation possible 
\^ere is the tip of tto cannula? 

Injection of gas or opening of jalve^ 
riatch for escape at cervix - ^ 

Auscultation 

Pressure, 

Ainount of gas. Rate of flow. 

Patient sits up. Shoulderpain. 

If streng, let h-r lay 

do- n. 

Interpretation : 

ilanometer, KymograpB 
Shoiolderpain 
delayed« 



••miltHä immn » •■nnNi i W i witiKni l fc i 




r 



n 



If closed: 
200 :m 
Don»t exceed. Experiments. 

If gas pnsses at looinri and higher 
partial block. 
May be caiised by spasme or ty 
adheslons. 

Location of pain glve hint of locatlon 
of blockage. 
medlcation. 



/ 



00? SHWX %u 



CNSPWMfei^raM akoN«^'«!« S4 



r 



n 



Ftfteo Photogrtph Hei« 



NEW YORK UNIVERSITY POST-GRADUATE MEDICAl; SCHOOL 

477 FIRST AVENUE, NEW YORK 16, N. Y. 

APPLICATION FOR ADMiSSION TO POSTGRADUATE COURSES 



Last Name First Name MiddleName 

Permanent Address 

Present Address Telephone No. 

Age Sex Citizenship Marital Status 

Attended Medical School from To Degrec 



HOSPITAL INTERNSHIPS OR RESIDENCIES: 
(1) 



(Name of Hospital) 



(Name of Hospital) 



(City) 
(City) 



(State) 
(State) 



From 
From 
From 



To 
To 
To 



(2) 
(3) 

(Name of Hospital) (City) (State) 

State below the nature of each of the internships or residencies (/.^., whether rotating, medical or surgical) : 
(1). (2) (3) 



PREVIOUS GRADUATE OR POSTGRADUATE MEDICAL STUDY: 



(Subject) 
(Subject) 



(School) 
(School) 



From 
From 
From 



To 
To 
To 



Licenscd to practice medicine in {state) (k^'*) License No. 

Type of Practice {inäicate whether gener al, including obstetrks and pediatrics, or confined to a specialty) : 

Of what professional organizations are you a member? 



PRESENT HOSPITAL AFFILIATIONS: 



(Hospital) 



(City) 



(Appointment and Service) 



(Hospital) (City) (Appointment and Service) 

Military Service {with dates and brief indication of type of professional experience) 



Date Appointed 
Date Appointed 



m 



i 



I 



\ 



Specialty Board certification 

(Date) (Board) 

Other evidence of specialist qualifications {membership in special academies, Colleges, etc.) 



Scientific Publications {use reverse of this blank or an attachment if necessary) 



1 HEREBY APPLY FOR ADMISSION TO THE FOLLOWING COURSES: 

No , Subject Beginning 

No Subject Beginning 

No Subject Beginning 

No Subject Beginning 



Date 

Approved 



(Signatare of Applicant) 



/ 






>^* J-^tk-iW.* -J^-lJ -^' l. , ' - I . ' ■■ » '— ^" 



/ 




VOL. LH., NO. 25 



i 



MAY P>, 19 52 



COURSES FOR PHYSICIANS 



POST-6RADUATE 

MEDIC AL SCHO OL 



I 



K) 




71ST SESSION 



1952-1953 



NOTICE 

The procedures of admission, the program of Instruction, including 
degree requirements, the schedule of fees, and the personnel of the 
teaching staff and their respective assignments announced in this bul- 
letin are subject to such changes, at any time, as may be deemed neces- 
sary or advisable by the administration. Any course of Instruction may 
be discontinued before completion if the administration deems such 
discontinuance for the best interests of the University. Upon discon- 
tinuance, the University will refund to students in good Standing all 
fees for Instruction in such course. 



NEW YORK UNIVERSITY 



POST-6RADUATE 
MEDICAL SCHOOL 



NEW YORK UNIVERSITY BULLETIN 



Vol. LH, No. 25 



May 19, 1952 



Published weekly from December, for forty-five consecutive weeks, by 
New York University, Main Building, 100 Washington Square Hast, 
New York 3, N.Y. Re-entered as second-class matter December 5, 
1951, at the Post Office at New York, N.Y., under the Act of August 
24, 1912. Acceptance for mailing at special rate of postage provlded 
for in Section 1 103, Act of October 3, 1917, authorized June 17, 1924. 



1952-1953 



A Unit of New York University-Bellevue Medical Center 
477 FIRST AVENUE • NEW YORK 16 • NEW YORK 



The teaching program is carried out in the lahoratories and 
Conference rooms of the University and in the following hospitals. 

Beekman-Downtown Hospital 

Bellevue Hospital 

Beth Israel Hospital 

Goldwater Memorial Hospital 

Gouverneur Hospital 

Irvington House 

Lenox Hill Hospital 

New York Eye and Ear Infirmary 

New York State Rehabilitation Hospital 

St. Vincent's Hospital 

University Hospital 

Willard Parker Hospital 



OFFICERS OF ADMINISTRATION 

Robert Boggs, A.B., M.D.,C.M. [McGill], Dean 

Clarence E. de la Chapelle, B.S. (Med.), M.D., Associate Dean 

C. Travers Stepita, M.S., M.D., Associate Dean (Foreign Student Affairs) 

Frode Jensen, A.B., M.D., Associate Dean 
Katherine L. Stevens, Recorder 



PROFESSORS EMERITI 

Walter T. Dannreuther, M.D., Obstetrics and Gynecology 

Austin Flint, A.M. (Hon.), M.D., Obstetrics 

Howard Fox, A.B., M.D., Sc.D. (Hon.), Dermatology and Syphilology 

Emanuel D. Friedman, B.S., M.D., Neurology 

Charles Gottlieb, M.D., Radiology 

Daniel B. Kirby, A.B., A.M., M.D., LL.D., Ophthalmology 

Arthur Krida, M.D., Orthopedic Surgery 

Walter G. Lough, B.S., M.D., Medicine 

George Miller MacKee, M.D., Dermatology and Syphilology 

Alfred T. Osgood, A.B., M.D., Vrology 

Charles Hendee Smith, B.S., M.D., Pediatrics 



« J 



CALENDAR OF COURSES 
1952-1953 



CALENDAR OF COURSES, 1952-1953 (continueä) 



DATE 



COURSE 



DATE COURSE 

July 

1 Dermatology and Syphilology 
Medicine 

7 Medicine 
14 Medicine 

Medicine 
Ophthalmology 
Ophthalmology 
Physical Medicine and 
Rehabilitation 
21 Medicine 

Ophthalmology 
Ophthalmology 

Sepiember 

2 Anesthesiology 
Anesthesiology 
Obstetrics and Gynecology 

8 Medicine 
Pediatrics 
Surgery 

9 Surgery 
11 Medicine 

15 Obstetrics and Gynecology 
Obstetrics and Gynecology 
Otolaryngology 
Otolaryngology 
Pediatrics 

Radiology 

16 Pathology 

17 Pathology 

22 Dermatology and Syphilology 

Medicine 

Ophthalmology 

Pediatrics 

Physical Medicine and 
Rehabilitation 

Psychiatry and Neurology 

Psychiatry and Neurology 
29 Comprehensive Medicine 

Anatomy 

Ahatomy 

Anatomy 

Anesthesiology 

Forensic Medicine 

Industrial Medicine 

Medicine 

Ophthalmology 

Otolaryngology 

Otolaryngology 

Otolaryngology 

Pathology 

Physical Medicine and 
Rehabilitation 

Psychiatry and Neurology 

Psychiatry and Neurology 



NUMBER DATE 



COURSE 



NUMBER 



525-A 
5429-A 
5414-A 
5424-A 
5430-A 

579-A 
5710-A 

731 1-A 

5422-A 
571 1-A 
5713-A 



-A 
-A 
-A 

-A 
A 
A 



513-A 

512-A 

734- 

5427- 

614- 

663- 

6610- 

5433- 

563-A 

566-A 

591-A 

592-A 

618-A 

652-A 

442-A 

44 1-A 

524-A 

5420-A 

5714-A 

6110-A 

7310-A 

647-A 

648-A 

740-A 

41 1-A 

413- 

414- 

514- 

531 

481 
5429- 

576- 

593- 

596- 
591 1-A 

443-A 



■A 

■A 

-A 

■A 

A 

A 

A 

A 

A 



Ocloher 

1 Dermatology and Syphilology 

Radiology 
3 Radiology 

6 Medicine 
Medicine 
Neurosurgery 
Obstetrics and Gynecology 
Pediatrics 

7 Obstetrics and Gynecology 
Obstetrics and Gynecology 

13 Medicine 

Obstetrics and Gynecology 
Orthopedic Surgery 

14 Obstetrics and Gynecology 

20 Physical Medicine and 

Rehabilitation 

21 Radiology 
27 Medicine 

Medicine 

Obstetrics and Gynecology 

Ophthalmology 

'J^ovember 

3 Ophthalmology 

Otolaryngology 

Pediatrics 
10 Medicine 

Medicine 

Medicine 

Ophthalmology 

Ophthalmology 

Otolaryngology 

Surgery 

Urology 
17 Medicine 

Medicine 
24 Otolaryngology 

Becember 



1 Surgery 

8 Industrial Medicine 

Obstetrics and Gynecology 

Otolaryngology 

Surgery 

Jauuary 

5 Anatomy 

Anatomy 

Anatomy 

Anatomy 
738-A Anesthesiology 

645-A Orthopedic Surgery 

649-A Orthopedic Surgery 



525-A 
65 1-A 
651-B 

546-A 
5434-A 
551-A 
561-A 
612-A 
567-A 
568-A 
542 1-A 
560-A 
582-A 
569-A 

7312-A 
655-A 

5424-B 

5435-A 

562-A 

574-A 



577-A 

597-A 

61 1-A 

5414-B 

5415-A 

5422-B 

575-A 

578-A 

594-A 

661 1-A 

674-A 

5418-A 

5423-A 

598-A 



664-A 

484-A 
564-A 
599-A 
666-A 



412-A 
413-A 
415-A 
416-A 
512-B 
581-A 
583-A 



January (cont'd) 

Radiology 

Surgery 

Surgery 

Urology 

Otolaryngology 

Preventive Medicine 

Psychiatry and Neurology 

Psychiatry and Neurology 

8 Pathology 
12 Medicine 

Neurosurgery 

Pediatrics 

Physical Medicine and 

Rehabilitation 
Physical Medicine and 

Rehabilitation 
Psychiatry and Neurology 

19 Dermatology and Syphilology 
Ophthalmology 
Ophthalmology 
Otolaryngology 
Pediatrics 

Physical Medicine and 

Rehabilitation 
Surgery 

20 Pathology 

26 Ophthalmology 
Ophthalmology 
Surgery 

28 Medicine 

29 Radiology 

lebruary 

2 Anesthesiology 

Industrial Medicine 

Medicine 

Surgery 
5 Medicine 

9 Otolaryngology 
16 Radiology 

18 Medicine 

23 Medicine 

Obstetrics and Gynecology 

Ophthalmology 

Ophthalmology 

24 Obstetrics and Gynecology 

21arch 

2 Industrial Medicine 

Medicine 
9 Medicine 

Ophthalmology 



NUMBER 


DATE COURSE 






Pediatrics 


653-A 


16 


Medicine 


665-A 




Ophthalmology 


66 1-A 


17 


Pathology 


672-A 


23 


Microbiology 


5910-A 




Obstetrics and Gynecology 


735-A 




Obstetrics and Gynecology 


64 1-A 




Ophthalmology 


644-A 




Surgery 


444-A 


30 


Anatomy 


5436-A 




Anatomy 


552-A 




Anatomy 


617-A 




Medicine 
Ophthalmology 


738-B 




Surgery 


7310-B 


AP 


ri\ 


643-A 


1 


Pediatrics 


522-A 


2 


Pediatrics 


579-B 




Surgery 


5710-B 


7 


Pediatrics 


595-A 


13 


Medicine 


613-A 




Medicine 
Medicine 


7312-B 




Medicine 


660-A 




Obstetrics and Gynecology 


441-B 


14 


Medicine 


5711-B 




Medicine 


5713-B 




Medicine 


662-A 




Obstetrics and Gynecology 


5426-A 




Obstetrics and Gynecology 


654-A 


15 


Medicine 
Medicine 
Medicine 




16 


Medicine 


510-A 




Medicine 


482-A 


17 


Medicine 


5427-B 




Medicine 


668-A 


20 


Physical Medicine and 


5433-B 




Rehabilitation 


594-B 






652-B 


'May 


543 1-A 

5420-B 

562-B 


11 
18 


Anesthesiology 
Dermatology and Syphilology 
Medicine 


575-B 






578-B 


lune 


569-B 


15 


Medicine 
Medicme 
Neurosurgery 


483-A 




Orthopedic Surgery 


5428-A 




Radiology 


5416-A 


22 


Medicine 


571-A 


29 


Medicine 



NUMBER 

614-B 
5415-B 
572-A 
442-B 
432-A 
563-B 
566-B 
574-B 
667-A 
411-B 
413-C 
414-B 
5423-B 
573-A 
661-B 



619-A 
615-A 
669-A 
616-A 
54 1-A 
547-A 
548-A 
549-A 
561-B 
542-A 
546-B 

5413-A 
567-B 
568-B 
545-A 

5410-A 

541 1-A 
544-A 
544-B 
543-A 

5412-A 

7312-C 



5 1 2-C 

523-A 
5432-A 



5419-A 

542 1-B 

553-A 

582-B 

656-A 

5418-B 

5425-A 



ANATOMY 



ANATOMY 



ANATOMY 

College of Mediane 



Donal Sheehan, b.s., m.s., m.b.,ch.b., m.d., sc.d. [Man- 
chester], Professor and Chairman of the Department 
Louis L. Bergmann, m.d., Associate Professor 
Pinckney J. Harman, b.s., m.s., ph.d., Associate Professor 
Joseph Pick, m.d. [vienna], Associate Professor 
Benjamin G. P. Shafiroff, m.d., Associate Professor of 

Clinical Surgery (Assigned to Anatomy) 
Joseph M. Odiorne, b.s., a.m., ph.d., Assistant Professor 
Louis M. Rosati, b.s., m.d., Assistant Professor of Clini- 
cal Surgery (Assigned to Anatomy) 

The foUowing courses may be taken füll time by 
special arrangement on a prorata basis of $100.00 per 
month. 
41 1-A. ANATOMY OF THE HEAD AND NECK 

A twelve weeks' course, 1 to 5 p.m., Mondays, 
Wednesdays, and Fridays, September 29 through 
Decembcr 19, 1952. Designed for graduate students 
iuterested in the fields of ophthalmology, otorhino- 
laryngology, or gcncral or thoracic surgery. The fas- 
cial planes of the neck and their continuities are inten- 
sively studied. The surgical anatomy of the thyroid 
gland, parathyroid glands, pharynx, and larynx are 
dissected in detail. Other special studies involve the 
recurrent laryngeal nerves, the superior laryngeal 
nerves, the sympathetic nervous System, and the caro- 
tid sinus mechanism. Surgical aspects are considered 
in relation to practical anatomy. 

Given under the direction of Dr. Benjamin G. P. 
Shafiroff. Tuition $90.00. 

This course is repeated as 4 1 1 -B, March 30 through 
June 19, 1953. 

412-A. ANATOMY OF THE THORAX AND ITS 
VISCERA 

A twelve weeks' course, 1 to 5 p.m., Mondays, 
Wednesdays, and Fridays, January 5 through March 
27, 1953. It is designed primarily for the thoracic or 
general surgeon or internist. The thoracic bony cage 
is completely dissected. The anatomy of the lung is 
studied in detail especially from the Standpoint of 
bronchovascular segments. The mediastinum is care- 
fuUy investigated. The cardiovascular structures are 
studied with recent developments in cardiac surgery. 
Congenital anomalies are considered. The surgical 
anatomy of the esophagus, autonomic nervous system, 
and lymphatic system are included. 

Given under the direction of Dr. Benjamin G. P. 
ShafirofT. Tuition $90.00. 



Seelig Freund, b.s., m.d., Instructor in Surgery (Assigned 

to Anatomy) 
May B. Hollinshead, a.b., ph.d., Instructor 
Maude V. Vance, a.b., m.d., Instructor 
Harold S. Auerhan, a.b., m.d., Assistant 
Henry Huber, a.b., m.d., Assistant 
Quan Y. Kau, a.b., m.d., Assistant 
Eugene P. Liston, a.b., m.d., Assistant 
Bernard O. Nemoitin, a.b., a.m., m.d., Assistant 
Marvin P. Rhodes, a.b., m.d., Assistant 
Morton Roberts, a.b., m.d., Assistant 
Henry L Scheer, b.s., m.d., Assistant 

413-A. ANATOMY OF THE ABDOMEN 

A twelve weeks' course, 1 to 5 p.m., Mondays, 
Wednesdays, and Fridays, September 29 through 
December 19, 1952. A dissection course of the entire 
abdomen and pelvis. Variational anatomy is particu- 
larly stressed. All organs are studied from the surgical 
Standpoint. The genitourinary system and viscera of 
pelvis are included. The surgical anatomy of hernia is 

stressed. 

Given under the direction of Dr. Benjamin G. P. 

Shafiroff. Tuition $90.00. 

This course is repeated as 413-B, January 5 
through March 27, 1953, and as 413-C, March 30 
through June 19, 1953. 

414-A. ANATOMY OF THE FEMALE PELVIS 

A twelve weeks' course, 1 to 5 p.m., Mondays, 
Wednesdays, and Fridays, September 29 through 
December 19, 1952. It is a practical dissection course 
of the female pelvis. The pelvic fascia and their practi- 
cal applications are stressed. The perineum is dis- 
sected in detail. All the pelvic viscera and their 
surgical relationships are correlated. The pelvic auto- 
nomic System is dissected. 

Given under the direction of Dr. Benjamin G. P. 
Shafiroff. Tuition $90.00. 

This course is repeated as 414-B, March 30 
through June 19, 1953. 

415-A. ANATOMY OF THE GENITOURINARY 
SYSTEM 

A twelve weeks' course, 1 to 5 p.m., Mondays, 
Wednesdays, and Fridays, January 5 through March 
27, 1953. It Combines the general features of 413 and 
414. 

Given under the direction of Dr. Benjamin G. P. 
Shafiroff. Tuition $90.00. 



416-A. ANATOMY OF THE MUSCULOSKELE- 
TAL SYSTEM 

A twelve weeks' course, 1 to 5 p.m., Mondays, 
Wednesdays, and Fridays, January 5 through March 
27, 1953. It is a general dissection course of the mus- 



culoskeletal system involving the upper and lower 
extremities, the muscles of the back, and their neuro- 
vascular structures. 

Given under the direction of Dr. Benjamin G. P. 
Shafiroff. Tuition $90.00. 



I 



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Instruction in Applied Anatomy 



ANESTHESIOLOGY 



ANESTHESIOLOGY 



ANESTHESIOLOGY 



Emery A. Rovenstine, a.b.. m.d.. sc.d. (hon.), Professor 

and Chairman of the Department 
Raphael W. Robertazzi, b.s., dot. med. chir. [naples], 

Professor of Clinical A nesthesia 
Seymour Goldenberg, a.b., m.d., Associate Professor of 

Clinical A nesthesia 
Louis R. Orkin, a.b., m.d., Assistant Professor 
Solomon G. Hershey, e.s., m.d., Clinical Professor 

513-A. ANESTHESIOLOGY (GRADUATE 
COURSE) 

The Instruction, largely clinical, with special 
classes, demonstrations, Conferences, etc., occupies 
the Student füll time during one calendar year, begin- 
ning September 2, 1952. Intensive didactic, seminar, 
and laboratory study in the basic medical sciences as 
applied to anesthesia is included. The major subjects 
are anatomy, physiology, pharmacology, pathology, 
biochemistry and biophysics, experimental anesthesia, 
inhalation thcrapy, and toxicology. 

Students who satisfactorily complete the first year 
of work may continue their training in residence for a 
minimum of one year. The residency must be ap- 
proved by the Post-Graduate Medical School. It offers 
the Student an opportunity to undertake individual 
original investigation in some phase of clinical experi- 
mental anesthesia. 

Given under the direction of Professor Emery A. 
Rovenstine. Maximum class 6. Tuition $700.00. 
(Enrollment after September 2, 1952, by arrange- 
ment. ) 

510-A. ANESTHESIOLOGY: 
ENDOTRACHEAL AND RELATED METHODS 

A one-week, full-time course, February 2 through 
7, 1953, covering the principles and clinical practices 
of endotracheal procedures including operating-room 
bronchoscopy. Two hours daily are given to didactic 
Instruction, the remainder of the time to supervised 
clinical work. Only those actively engagcd in clinical 
anesthesiology are accepted. 

Given under the direction of Professor Emery A. 
Rovenstine. Maximum class 4. Tuition $75.00. 

511-A. ANESTHESIOLOGY (FOR 
SPECIALISTS) 

An intensive refresher course of two weeks' dura- 
tion beginning on any Monday (September through 
June). The present practices in general, regional, 
intravenous, and rectal anesthesia are presented from 
the theoretical and clinical Standpoints. 



M.D., Associate Clinical 



Donald L. Burdick, b.s., a.m., 

Professor 
Charles L. Burstein, b.s., m.d. [paris], Associate Clinical 

Professor 
Jack Milowsky, s.S., m.d., Associate Clinical Professor 
James Marin, a.b., m.d., Assistant Clinical Professor 
D. Jeanne Richardson, b.s., m.d., Assistant Clinical Pro- 
fessor 

Given under the direction of Professor Emery A. 
Rovenstine. Maximum class 2. Tuition $150.00. 

512-A. REGIONAL ANESTHESIOLOGY 

An intensive two-week course in regional anes- 
thesia, including therapeutic nerve blocking. The 
entire'day is utilized to present the subject by cadaver 
dissection, lectures, clinical demonstration, and prac- 
tice. September 2 through 13, 1952. 

Given under the direction of Professor Emery A. 
Rovenstine. Maximum class 16. Tuition $200.00. 

This course is repeated as 512-B, January 5 
through 16, 1953, and as 512-C, May 11 through 22, 
1953. 
514-A. ANESTHESIOLOGY 

A full-time course of twelve weeks' duration, Sep- 
tember 29 through December 19, 1952. One half of 
the student's day is occupied live days weekly with 
assigned exercises in classrooms and laboratories 
covering the fundamental sciences of physiology, 
pharmacology, therapeutics, anatomy, pathology, 
toxicology, physics, and chemistry in their relation to 
anesthesiology. Practical supervised instruction m 
clinical anesthesia and its related practices occupies 
the remainder of the student^s day. 

A Student may arrange to take the first, second, 
and/or third sessions of the course. The clinical 
instruction given mornings is consistent throughout 
the course. Afternoons: 

Part I-September 29 through October 24, 1952. 
Didactic instruction in the fundamental sciences in 
their relation to anesthesiology. 

Part Il-October 27 through November 21, 1952. 
Didactic instruction in clinical anesthesiology. 

Part III-November 24 through December 19, 
1952. Didactic instruction in subjects related to the 
clinical practice of anesthesiology. Inhalational and 
parenteral therapy, management of comatose states, 
etc. 

A practical knowledge of modern anesthesia is a 
prerequisite. Given under the direction of Professor 
Emery A. Rovenstine. Maximum class 24. Tuition 
$300.00. (Any four weeks $125.00.) 



8 



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Practical Demonitration of Modern Anesthesia 



CHEMISTRY 



DERMATOLOGY AND SYPHILOLOGY 



CHEMISTRY 



College of Mediane 



DERMATOLOGY AND SYPHILOLOGY 



R. Keith Cannan, b.s., m.s., sc.d. [london], Professor 

and Chairman of the Department 
Isidor Greenwald, a.b., ph.d., Professor 
Milton Levy, e.s., ph.d., Associate Professor 
Maxwell Schubert, a.b.. a.m., ph.d., Adjunct Associate 

Professor (Assigned to Mediane) 
Albert S. Keston, a.b., m.s. ph.d., Assistant Professor 
Robert C. Warner, b.s., m.s., ph.d., Assistant Professor 
Hildegard Wilson, a.b., a.m., ph.d., Assistant Professor 

(Assigned to Mediane) 
Mary E. Dumm, a.b., a.m., ph.d., Adjunct Assistant Pro- 
fessor (Assigned to Mediane) 
Walton B. Geiger, a.b., ph.d., Adjunct Assistant Professor 
(Assigned to Medicine) 

Integration of Clinicol Problems with Loborotory Techniques 




ä0^. 



lone Weber, b.s., a.m., ph.d., Adjunct Assistant Professor 

Mary E. Carsten, a.b., m.s., ph.d., Fellow 

Joseph Dancis, a.b., m.d., Fellow 

Seymour Ehrenpreis, b.s., Fellow 

Jacques R. Fresco, a.b., m.s., Fellow 

Cliflford Jackson, b.s., m.s., Fellow 

Kenneth C. Leibman, b.s., m.s., Fellow 

Joseph Lospalluto, b.s., Fellow 

Evelyn Slobodiansky, a.b., m.s., ph.d., Fellow 

The members of the department take part in the basic 
science instruction in the courses offered by the clinical 
departments. 






f 








/ 



/i 



Marion B. Sulzberger, m.d. [zurich], Professor and 
Chairman of the Department 

Frank C. Combes, m.d., Professor 

Evan W. Thomas, a.b., m.d., Professor of Clinical Medi- 
cine (Assigned to Syphilology) 

Franz Herrmann, m.d. [Frankfurt], Associate Professor 

Rudolf L. Baer, m.d. [Frankfurt], Associate Professor 
of Clinical Dermatology and Syphilology 

David Bloom, m.d. [bern], Associate Professor of Clini- 
cal Dermatology and Syphilology 

Maurice J. Costello, b.s., m.d., Associate Professor of 
Clinical Dermatology and Syphilology 

Max Jessner, m.d. [koenigsberg], Associate Professor of 
Clinical Dermatology and Syphilology 






> ■ U ^ 



#i 



Frances Pascher, m.d., Associate Professor of Clinical 
Dermatology and Syphilology 

Charles R. Rein, b.s., m.d., Associate Professor of Clini- 
cal Dermatology and Syphilology 

Herman Sharlit, a.b., b.s., m.d., Associate Professor of 
Clinical Dermatology and Syphilology 

Nathan Sobel, m.d., Associate Professor of Clinical Der- 
matology and Syphilology 

Jesse A. Tolmach, m.d., Associate Professor of Clinical 
Dermatology and Syphilology 

Jack Wolf, A.B., M.D., Associate Professor of Clinical 

Dermatology and Syphilology 
Morris Leider, a.b., m.d., Assistant Professor 

Practical Instruction in Examination Technique of Skin 




f 



r 





DERMATOLOGY AND SYPHILOLOGY 



Gerald Flaum, a.b., m.d., med.sc.d., Assistant Professor 

of Clinical Medicine (Assigned to Syphilology) 
Louis Schwartz, a.b., m.d.. Adjimct Clinical Professor 
David B. Ball in, m.d.. Associate Clinical Professor 
Else Ann Barthel, b.s., m.d.. Associate Clinical Professor 
Hans H. Biberstein, m.d. [Breslau], Associate Clinical 

Professor 
Orlando Canizares, doc. univ. [med. fac, paris], Asso- 
ciate Clinical Professor 
William Director, m.d.. Associate Clinical Professor 
Samuel B. Frank, a.b.. m.d., Associate Clinical Professor 
Andrew G. Franks, b.s., m.d., ll.b.. Associate Clinical 

Professor 
Herman Goodman, b.s.. m.d.. Associate Clinical Pro- 
fessor 
Irving N. Holtzman, m.d.. Associate Clinical Professor 
Arthur B. Hyman, m.b., b.s. [london], Associate Clinical 

Professor 
Samuel Irgang, m.d.. Associate Clinical Professor 
Paul R. Kline, m.d., Associate Clinical Professor 
William Leifer, m.d., Associate Clinical Professor 
John F. Mahoney, m.d., Associate Clinical Professor 
H. Victor Mendelsohn, m.d.. Associate Clinical Professor 
Joseph L. Morse, m.d., Associate Clinical Professor 
Emanuel Muskatblit, physician [odessa], Associate Clin- 
ical Professor 
Ernst W. Nathan, m.d. [giessen], Associate Clinical Pro- 
fessor 
Frederick Reiss, m.d. [Budapest], Associate Clinical 

Professor 
Timothy J. Riordan, m.d.. Associate Clinical Professor 
Gdali Rubin, m.d. [paris], Associate Clinical Professor 
Lionel C. Rubin, a.b.. m.d.. Associate Clinical Professor 
Herman H. Sawicky, b.s., m.d. [Edinburgh], Associate 

Clinical Professor 
Charles F. Sims, a.b., m.d., Associate Clinical Professor 
Howard T. Behrman, a.b., m.d., Assistant Clinical Pro- 
fessor 
Frank E. Gross, m.d., med.sc.m., Assistant Clinical Pro- 
fessor 
Lopo de Mello, m.d., Assistant Clinical Professor 
Richard Emmet, a.b., m.d., Assistant Clinical Professor 
Alexander A. Fisher, a.b., m.d., Assistant Clinical Pro- 
fessor 
John Garb, m.d.. Assistant Clinical Professor 
Thomas N. Graham, m.d., Assistant Clinical Prof essor 
Joseph Hahn, b.s.. m.d., Assistant Clinical Professor 
Delmas K. Kitchen, a.b. (chem.), b.s. (med.), m.d., 

Assistant Clinical Professor 
Ralph L Kreisberg, b.s. (med.), m.d., Assistant Clinical 

Professor 
Emory Ladany, m.d. [Budapest], Assistant Clinical Pro- 
fessor 
Simeon E. Landy, a.b., Assistant Clinical Professor 
Juan Larralde, m.d. [paris], med.sc.d. [univ. central, 

VENEZUELA], Assistant Clinical Professor 
Charles S. Miller, a.b., m.d., Assistant Clinical Professor 
Abraham J. Orfuss, b.s., m.d., Assistent Clinical Professor 
Julius H. Pollock, B.S., m.d., Assistant Clinical Professor 
Morris J. Rothstein, b.s., yi.n., Assistant Clinical Professor 



Ludwig Schwarzschild, m.d. [wuerzburg], Assistant 

Clinical Professor 
Mabel G. Silverberg, a.b., m.d., Assistant Clinical Pro- 
fessor 
Jacob Skeer, m.d., Assistant Clinical Professor 
Jacob Wachtel, m.d., Assistant Clinical Professor 
Jacob A. Goldberg, a.b., a.m., ph.d., Lecturer 
Theodore Rosenthal, b.s., m.d., Lecturer 
Joseph R. Klaar, m.d. [vienna], Instructor 
Ludwig S. Kleeberg, m.d. [jena], Instructor 
Ludwig W. Loewenstein, m.d. [cologne], Instructor 
Nathan Pensky, a.b., m.d., Instructor 
Max Wolf, M.D. [vienna], Instructor 
Isidor Apfelberg, m.d., Instructor in Clinical Dermatol- 

ogy and Syphilology 
Benjamin Bender, b.s., m.d., Instructor in Clinical Der- 

matology and Syphilology 
Vagharshag Boghosian, m.d. [beyrouth], Instructor in 

Clinical Dermatology and Syphilology 
Max Braitman, b.s., m.d., Instructor in Clinical Derma- 
tology and Syphilology 
Theodore H. Finkle, a.b., m.d., Instructor in Clinical Der- 
matology and Syphilology 
Abraham J. Gewirtz, b.s., m.d. [laval], Instructor in 

Clinical Dermatology and Syphilology 
John Groopman, b.s., m.d., Instructor in Clinical Derma- 
tology and Syphilology 
Ernest L. Kadisch, m.d. [freiburg], Instructor in Clini- 
cal Dermatology and Syphilology 
Kate Freeman Miller, a.b., m.d., Instructor in Clinical 

Dermatology and Syphilology 
Helen Neave, a.b., m.d., Instructor in Clinical Dermatol- 
ogy and Syphilology 
Laurence L. Palitz, a.b., ph.d., m.d., Instructor in Clinical 

Dermatology and Syphilology 
Morris M. Reschke, m.d. [berlin], Instructor in Clinical 

Dermatology and Syphilology 
Sidney J. Robbins, b.s., m.d. [vienna], Instructor in Clini- 
cal Dermatology and Syphilology 
Ernst Rosenbaum, m.d. [Breslau], Instructor in Clinical 

Dermatology and Syphilology 
Walter F. Rosenberg, m.d. [Heidelberg], Instructor in 

Clinical Dermatology and Syphilology 
Gerald A. Spencer, b.s.; doc. univ. [med. fac, lyon], 

Instructor in Clinical Dermatology and Syphilology 
Louis H. Tobin, m.d., Instructor in Clinical Dermatology 

and Syphilology 
Henry R. Corwin, a.b., m.d., Clinical Instructor 
Benjamin D. Erger, m.d., Clinical Instructor 
Hans Field, m.d., Clinical Instructor 
John Heinlein, m.d., Clinical Instructor 
Edward G. Jeruss, b.s., m.d., Clinical Instructor 
Norman B. Kanof, a.b., m.d., med.sc.d. (derm.), Clini- 
cal Instructor 
George H. Kostant, a.b., m.d., Clinical Instructor 
Irving L. Milberg, a.b., m.d., Clinical Instructor 
Julius L. Rosenfeld, m.d.,c.m. [dalhousie], Clinical In- 
structor 
Jessie Rubin, a.b., m.d. [Lausanne], Clinical Instructor 



12 



i«i#jijWipi.T' 



DERMATOLOGY AND SYPHILOLOGY 



Joseph J. Sher, b.s., m.d., Clinical Instructor in Radiology 
(Assigned to Dermatology) 

Hilda G. Straker, a.b., m.d., Clinical Instructor 

Victor H. Witten, b.s., m.d., Clinical Instructor 

Harold L. Adler, b.s., m.d., Assistant in Clinical Derma- 
tology and Syphilology 

Arthur Back, m.d., Assistant in Clinical Dermatology 
and Syphilology 

Earle Brauer, m.d., Assistant in Clinical Dermatology 
and Syphilology 

Elfriede W. Ehrenreich, m.d., Assistant in Clinical Der- 
matology and Syphilology 

William Eller, m.d., Assistant in Clinical Dermatology 
and Syphilology 

Martin Fischer, m.d., Assistant in Clinical Dermatology 
and Syphilology 

Dorothy Fisher, a.b., m.d., Assistant in Clinical Derma- 
tology and Syphilology 

Harold Glick, m.d., Assistant in Clinical Dermatology 
and Syphilology 

Morton Kulick, b.s., m.d., Assistant in Clinical Dermatol- 
ogy and Syphilology 

Rene Leviticus, m.d., Assistant in Clinical Dermatology 
and Syphilology 

Irwin L Lubowe, a.b., m.d., Assistant in Clinical Derma- 
tology and Syphilology 

Irving E. Marks, m.d., Assistant in Clinical Dermatology 
and Syphilology 

Martin G. Marmon, a.b., m.d., Assistant in Clinical Der- 
matology and Syphilology 



Frederick R. Mebel, a.b., m.d., Assistant in Clinical Der- 
matology and Syphilology 
■ Adrian Neumann, m.d., Assistant in Clinical Dermatol- 
ogy and Syphilology 

Leo Orris, a.b., m.s.(pub.health),m.d., Assistant in 
Clinical Dermatology and Syphilology 

George Popkin, m.d., Assistant in Clinical Dermatology 
and Syphilology 

Milton S. Ross, b.s., m.d.. Assistant in Clinical Derma- 
tology and Syphilology 

Adolph S. Sternberg, m.d. Ifreiburg], Assistant in Clin- 
ical Dermatology and Syphilology 

Jules E. Vandow, m.d., Assistant in Clinical Dermatology 
and Syphilology 

Harold S. Appell, m.d.. Fellow 

Alexander Borota, m.d. [Budapest]. Fellow 

Olga-Sophie Dobkevitch-Morrill, m.d. [paris], Fellow 

Ruth W. Piccagli, m.d. [frankfurtI, Fellow 

Philip H. Prose, b.s., m.d. Ilausanne], Fellow 

Norman Goldfarb, m.d.. Assistant in Clinical Dermatol- 
ogy and Syphilology 

So!t mon Goldman, b.s.. m.d., Assistant in Clinical Der- 
matology and Syphilology 

Otto B. Hitschmann, m.d. Ivienna], Assistant in Clinical 
Dermatology and Syphilology 

Beatrice Kalish, a.b., m.d.. Assistant in Clinical Derma- 
tology and Syphilology 

Leonard V. Kornblee, a.b.. m.d., Assistant in Clinical 
Dermatology and Syphilology 



525-A. DERMATOLOGY AND SYPHILOLOGY 
(GRADUATE COURSE) 

A full-time course of one calendar year, October 1 , 
1952, through September 30, 1953. (This course may 
be entered July 1, 1952.) Covers the basic science 
aspects of the specialty and consists of didactic lec- 
tures as well as practical and laboratory exercises in 
histopathology, mycology, bacteriology, physiology, 
heniatology, allergy and immunology, serology, radio- 
active isotopes, radiation and other physical therapy, 
and other basic fields as applied to the skin and its dis- 
eases and to venereal diseases. The facilities of the 
Skin and Cancer Unit, University Hospital, Bellevue 
Hospital, Willard Parker Hospital, and the other affili- 
ated hospitals are utilized. This course should be taken 
in conjunction with a two-year residency or in con- 
junction with a combined fellowship and preceptee 
training program to comprise a füll three-year training 
period. 

A limited number of scholarships are available. 

Given under the direction of Professor Marion B. 
Sulzberger. Tuition $700.00. 



521-A. AN INTENSIVE AND COMPREHEN- 
SIVE REVIEW IN DERMATOLOGICAL HISTO- 
PATHOLOGY 

A full-time intensive course of five days' duration 
consisting of a series of lectures, illustrated by micro- 
scopic slides. A complete review of both the normal 
histology of the skin and the essential histopathology 
of diseases of the skin. Includes study at the micro- 
scope and slides representing common and unusual 
microscopic features of dermatoses. The dates of this 
course will precede that of the examination by the spe- 
cialty board and will be announced in American medi- 
cal Journals. 

Given under the direction of Professor Marion B. 
Sulzberger. Maximum class 20. Tuition $75.00. 

522-A. SEMINAR IN DERMATOLOGY AND 
SYPHILOLOGY 

A full-time intensive course of five days' duration, 
January 19 through 23, 1953, consisting of illustrated 
lectures and demonstrations of patients and methods. 
The latest accepted methods used in the diagnosis and 



13 



ifw^rj^^s.i-ataitfi^'ifaf 



(■ta 



DERMATOLOGY AND SYPHILOLOGY 



FORENSIC MEDICINE 



therapy of the following dcrmatoses are included: pre- 
cancers and Cancers of thc skin; acne vulgaris; various 
forms of cczema; industrial dcrmatoses; warts; scars 
and birthmarks; fungus infcctions; bactcrial infections 
of the skin; psoriasis; liehen planus; allergic dcrma- 
toses, including various forms of cczema, hives, drug 
reactions, etc.; baldncss and excessive hair; syphilis in 
all stagcs, including discussion of Serologie changes. 
The usc of special modalities is dctailed, including: 
ACTH and Cortisone; other hormones; vitamins; anti- 
biotics; antihistaminics; and radioactive agents. 

Given undcr the direction of Professor Marion B. 
Sulzberger. Maximum class 20. Tuition $75.00. 

523-A. SYMPOSIUM ON DERMATOLOGY 
AND SYPHILOLOGY (FOR DERMATOLO- 
GISTS) 

A full-time course of five days' duration, May 18 
through 22, 1953, consisting of a survey and critical 
evaluation of recent advanecs and research in dcrma- 
tology and syphilology, including such subjccts as ra- 
dioactive isotopes, grenz-ray and thorium-X therapy; 
ACTH. Cortisone, and other new drugs and hormones; 
drug eruptions; new methods of treatment of common 
skin diseases; new causes for industrial dcrmatoses; 
the prcsent concept of cczema; management of benign 
and of dangerous nevi; diagnosis and management of 
Syphilis, lymphohlastomas. allergic skin diseases, fun- 
gus diseases; selected rare conditions; and the psy- 
chosomatic aspects of dermatology. Demonstration of 
patients and application of new techniques are 
included. 

Given under the direction of Professor Marion B. 
Sulzberticr. Maximum class 20. Tuition $85.00. 

524-A. DERMATOLOGY AND SYPHILOLOGY 
IN INFANTS AND CHILDREN 

An intensive full-time review course of five days' 
duration, September 22 through 26, 1952. Includes 
clinical scssions and demonstration of patients to- 
gether with the application of modern diagnostic and 



therapeutic modalities, iilustration of the common and 
rare skin diseases, illustrated lectures covering the dif- 
ferential diagnosis, causes and newest forms of treat- 
ment of nevi, tumors, warts, allergies, eczemas, 
urticarias, pyodermas, drug eruptions, acnes, psoria- 
sis, and other skin diseases as they occur in the young. 
Given under the direction of Professor Marion B. 
Sulzberger. Tuition $75.00. 

482-A. OCCUPATIONAL DERMATOSES (IN 
CONJUNCTION WITH THE DEPARTMENT OF 
INDUSTRIAL MEDICINE) 

A two-week, part-time course given under the 
direction of Dr. William Leifer (see page 16). 

735-A. TROPICAL MEDICINE 

Lectures on tropical fungus diseases given by mem- 
bcrs of the department in conjunction with the above 
listed course (see page 63). 

SHORT-TERM AND PRACTICAL COURSES IN 
DERMATOLOGY AND SYPHILOLOGY 

Part-time and full-time courses ranging from one 
weck to one year are available by arrangement, on a 
prorata basis of $125.00 per month, füll time. 

The applicant may select Instruction in one or more 
of the subdivisions of the specialty, including derma- 
tologic allergy; histopathology; mycology; dermatolo- 
gic hematology; photography; dermatologic therapy; 
dcrmatologic surgery; physical therapy — radiation 
therapy, use of isotopes and thorium X; venereal dis- 
eases and serology. 

Opportunities may be made available for qualified 
students to work on original laboratory and clinical 
research projects under the supervision of staff 
members. 

A prospectus may be obtained by writing to the 
Oflice of the Dean, Post-Graduate Medical School, 
477 First Avenue, New York 16, N.Y. 



FORENSIC MEDICINE 



14 



. 



Harrison S. Martland, a.b., m.d., Professor and Chairman 

of the Department 
Thomas A. Gonzales, m.d., Professor 
Milton Helpern, b.s., m.d., Associate Professor 
Rudolf M. Paltauf, m.d. [vienna], Assistant Professor 

531-A. FORENSIC MEDICINE (GRADUATE 
COURSE) 

Opportunity is provided for a few physicians to 
undertake advanced training in the field of forensic 
medicine. This study Covers a period of not less than 
one academic year, füll time, or an equivalent period 
on a part-time basis, beginning September 29, 1952. 

The course is given in the laboratories of the Chief 
Medical Examiner and the Toxicologist of the City of 
New York. Students work both in the laboratory and 
in the field and may undertake independent research. 
The first part of the period of study is spent chiefly in 
the basic medical sciences as related to forensic medi- 
cine; the latter is largely given over to applied work in 
the necropsy room, the toxicological laboratory, the 
field, and the courts. 

Given under the direction of Professor Harrison S. 
Martland. Tuition $700.00. 

532-A. FORENSIC MEDICINE 

Postgraduate courses of varying duration are of- 
fered in forensic medicine, on the prorata basis of 
$100.00 per month, füll time. 

533-A. TOXICOLOGY (DATES BY 
ARRANGEMENT) 

Section I. Three months. Introduction to Toxicological 
Procedures and Analysis for Gaseous Poisons. 

Methods and proctocol in the toxicological laboratory; 
collection of the samples for toxicological analysis; 
appropriate organs for particular toxicological analyses; 
information needed by the toxicologist prior to the analy- 
sis; relation between the pathologist and the toxicologist; 
handling evidence and establishing the chain of evidence; 
general procedures in toxicological analysis; qualitative 
and quantitative analysis for gaseous poisons. Tuition 
$300.00. 

Section IL Three months. Analysis for Volatile Poisons. 
Methods for the detection of volatile poisons isolated 
from tissue and body fluids by steam distillation. Empha- 
sis is placed on the qualitative methods for the identifica- 
tion of the wide variety of volatiles. Quantitative methods 
are considered only for the more common substances 
such as the alcohols, Cyanide, phenols, halogenated 
hydrocarbons, and commercial hydrocarbon mixtures. 
Tuition $300.00. 



Alexander S. Wiener, a.b., m.d., Assistant Professor 
Alexander O. Gettler, b.s., a.m., ph.d., ll.d., Lecturer 

(Toxicology) 
Charles J. Umberger, B.s., ph.d., Lecturer 



Section III. Six months. Inorganic Poisons. 
Subsection 1. Three months. Metallic Poisons. 

The period is devoted exciusively to learning the prin- 
ciples and manipulative techniques and plate interpreta- 
tion of spectrographic analysis. A study is made of the 
characteristic spectra of all the toxic metals. Tuition 
$300.00. 

Subsection 2. Three months. Quantitative Analysis of the 
Metals and Analysis of the Nonmetallic Inorganic 
Poisons. 

Preparation of biological samples for inorganic metal 
and nonmetal analysis and quantitative chemical methods 
for the common metal poisons. Qualitative and quantita- 
tive analysis for the inorganic nonmetallic poisons, such 
as phosphorus, fluorides, borates, nitrites, nitrates, and 
chlorates is also studied. 

Tuition $300. 

For füll six months, tuition $500.00. 

Section IV. Nine months. The Nonvolatile Organic 
Poisons. 

Subsection 1. Three months. Fundamental Techniques 
for the Analysis of Nonvolatile Organic Poisons. 

The period is devoted to the study of procedures for 
the isolation and purification of the organic drugs from 
tissue and body fluids, the development of micro-manipu- 
lative techniques which include micro-sublimation, mi- 
cro-manipulation, micro-melting points, the essentials of 
chemical microscopy, and carbon, hydrogen, and molecu- 
lar weight determinations. 

Subsection 2. Three months. Detection of the Acid-Type 
Nonvolatile Organic Poisons. 

The period covers the detection of the acid-type drugs 
with special attention to the barbiturates. 

Subsection 3. Three months. Detection of the Basic-Type 
Nonvolatile Organic Poisons. 

This period is devoted to methods for the detection 
and determination of the basic-type drugs, such as the 
narcotics, local anesthetics, antihistamines, etc. 

Tuition for nine months $700.00. 

Section V. Three months. Application of Instrumentation 
to Toxicological Analysis. 

Essentials of infrared and ultraviolet spectrophotome- 
try, high voltage technique in spectrographic analysis, 
special applications of conductometric and electrometric 
methods. Special procedures in forensic medicine, such 
as the comparison of physical evidence, detection of pow- 
der, determination of entrance and exit wounds. Tuition 
$300.00. 



15 



INDUSTRIAL MEDICINE 



INDUSTRIAL MEDICINE 



Anthony J. Lanza, m.d.. Professor and Chairman of the 

Department 
David H. Goldstein, a.b., m.d.. med.sc.d., Associate 

Professor 
Merril Eisenbud, b.s. (elec. engr.). Associate Professor 

(Industrial Hyfiiene) 
Norton Nelson, a.b., ph.d., Associate Professor 
Herman N. Eisen, a.b., m.d., Assistant Professor 
Sidney Laskin, a.b., Assistant Professor 
Edward D. Palmes, b.s., m.s., ph.d., Assistant Professor 
William E. Smith, a.b., m.d., Assistant Professor 
Edgar Mayer, a.b., m.d., Clinical Professor 
Ronald F. Buchan, a.b., m.d.,c.m. [mcgillI, Associate 

Clinical Professor 
Leonard Greenburg, c.e. (sanitary engr.), ph.d., m.d., 

Associate Clinical Professor 
Joseph P. Holt, B.S., M.S., ph.d., m.d., Associate Clinical 

Professor 
Willard F. Machle, b.s., m.d.. Associate Clinical Professor 

481-A. INDUSTRIAL MEDICINE (GRADUATE 
COURSE) 

A full-timc course of one calcndar year beginning 
September 29, 1952, in industrial mcdieinc and indus- 
trial hygiene givcn in the Institute of Industrial Medi- 
cine and the College of Engineering. Under a 
co-operative agreement with the College of Engineer- 
ing, this course is ofTered jointly to physicians and 
engineers. It comprises nine months of class and lab- 
oratory work and three months of in-plant vvork. The 
course includes the following: 

A. For physicians and engineers jointly 

Epidemiology, preventive medicine, and bio- 
statistics including Statistical procedures and 
analysis; the relationship of environmental 
conditions in work places to health and dis- 
ease; workmen's compcnsation and legal 
aspects. 

B. For physicians 

Organization, administration, and economics 
of an industrial medical department; occupa- 
tional diseases; roentgenology with particular 
reference to pulmonary diseases; psychiatry, 
geriatrics, and industrial relations; rehabilita- 
tion. 

C. For engineers 

Air conditioning, control of atmospheric pol- 
lution, disposal of industrial wastes; methods 
of sampling and analysis; illumination stand- 



Robert C. Page, a.b., m.b.. m.d., Associate Clinical Pro- 
fessor 
George M. Saunders, a.b., m.d., Associate Clinical Pro- 

fessor 
Frank R. Ferlaino, b.s., m.s., m.d., Assistant Clinical 

Professor 
Frank P. Guidotti, m.d. [naples], Assistant Clinical Pro- 
fessor 
Ralph F. Schneider, B.s., m.d., Assistant Clinical Pro- 
fessor 
Barnett S. Fox, Lecturer 

Nathan Van Hendricks, b.engr., ch.e., Lecturer 
Henry D. Sayer, Lecturer 
Royd R. Sayers, a.b., a.m., m.d., Lecturer 
Edward J. Stieglitz, b.s., m.s., m.d., Lecturer 
Arthur J. Vorwald, a.b., ph.d., m.d., ll.d., sc.d.(hon.), 

Lecturer 
George W. Wright, b.s., m.d., Lecturer 
Bernhard Altshuler, b.s. (engr.physics), Instructor 
Lawrence F. Dieringer, b.s. (chem.engr.), Instructor 
(Industrial Hygiene) 

ards and designs; accident and fire prevention; 
Physiologie effects of toxic substances and 
their maximum allowable concentrations. In- 
plant work is in approved industrial medical 
departments or approved industrial-hygiene 
laboratories. 
The institute maintains three laboratories for re- 
search and teaching-industrial toxicology, industrial 
physiology, and industrial hygiene. Students partici- 
pate in the work of these three laboratories. 

Given under the direction of Professor Anthony J. 
Lanza. Tuition $700.00. 

482-A. OCCUPATIONAL DERMATOSES 

A five-day, full-time course, February 2 through 6, 
1953, in the diagnosis, treatment, and prevention of 
occupational derniatoses. 

Given under the direction of Dr. William Leifer. 
Tuition $50.00. 

483-A. INDUSTRIAL MEDICINE 

An intensive three months' course in industrial 
medicine to be given March 2 through May 29, 1953. 
Designed for industrial physicians who wish to be- 
come conversant with the more recent developments 
in industrial medicine, cspecially in its preventive 
aspects. 

Given under the direction of Professor Anthony J. 
Lanza. Maximum class 25. Tuition $300.00. 



16 



INDUSTRIAL MEDICINE 



484-A. MEDICAL ASPECTS OF COMPENSA- 
TION 

A one-week course, December 8 through 13, 1952, 
given in co-operation with the American Academy of 
Compcnsation Medicine, covering the compcnsation 
aspects of the various medical spccialtics by specialists 
in cach field. 

Givcn under the direction of Professor Anthony J. 
Lanza in association with Dr. William B. Rawls of the 
American Academy of Compcnsation Medicine. Tui- 
tion $50.00. For mcmbcrs of the Academy, tuition 
$25.00. 



5432-A. PULMONARY DISEASES IN RELA- 
TION TO INDUSTRY 

A full-time course of five days' duration, May 18 
through 22, 1953, for the purpose of giving the 
matriculate a practical approach to the problems of 



industry in relation to thoracic disease. To this end, a 
brief background of pathoiogy and physiology is the 
basis for the presentations on the various illnesses and 
occupational diseases that are encountered. Emphasis 
is placed on treatment and rehabilitation, problems of 
extreme importance to the industrial physician. Some 
of the legal aspects of compensabie disease are 
touched. Ample opportunity is presented for forum 
discussion. 

Given under the direction of Dr. David Ulmar. Tui- 
tion $50.00. 

Short courses in various specialties of industrial 
medicine, including the pneumoconioses at the Sara- 
nac Laboratory, Saranac Lake, New York, are oflFered 
by special arrangement on a prorata basis of $100.00 
per month, füll time. 

Courses in industrial hygiene engineering are given 
in co-operation with the College of Engineering. For 
further information consult the Graduate Division 
bulletin of the College. 



17 



MEDICINE 



MEDICINE 



Charles F. Wilkinson, Jr., b.s.(chem.engr.), m.d., Pro- 
fessor and Chairman of the Department 
Clarence E. de la Chapelle, b.s. (med.), m.d., Professor 
Charles A. Poindexter, b.s., m.d., m.s., Professor 
A. Wilbur Duryee, b.s., m.d., Professor of Clinical Medi- 

cine 
Charles H. Nammack, a.b., m.d., Professor of Clinical 

Medicine 
Will C. Spain, a.b., m.d., Professor of Clinical Medicine 
Maurice Bruger, b.s., m.s., m.d.,c.m. [mcgill], Associate 

Professor 
J. Scott Butterworth, b.s., m.s., m.d., med.sc.d., Associate 

Professor 
Raymond S. Jackson, m.d., Associate Professor 
Benjamin I. Ashe, b.s., m.d., Associate Professor of Clin- 
ical Medicine 
Irving Graef, a.b., m.d., Associate Professor of Clinical 

Medicine 
Robert McGrath, b.s., m.d., Associate Professor of Clin- 
ical Medicine 
Lester J. Unger, a.b., a.m., m.d., Associate Professor of 

Clinical Medicine 
Laurence G. Wesson, Jr., a.b., m.d., Assistant Professor 
Charles A. R. Connor, a.b.. m.d., med.sc.d., Assistant 

Professor of Clinical Medicine 
Maximilian Fabrykant, m.d. [charles un;v., prague], 

Assistant Professor of Clinical Medicine 
J. Russell Twiss, a.b., m.d., Assistant Professor of Clin- 
ical Medicine 
Arthur M. Fishberg, a.b., m.d., Clinical Professor 
Edgar A. Lawrence, b.s. [mcgill], m.d., Clinical Pro- 
fessor 
Henry A. Rafsky, m.d., Clinical Professor 
Emanuel Appelbaum, a.b., m.d., Associate Clinical Pro- 
fessor 
Joseph Eideisberg, m.d., Associate Clinical Professor 
Abner M. Fuchs, m.d., Associate Clinical Professor 
Clarence C. Füller, b.s., m.d., Associate Clinical Professor 
Eimer S. Gais, b.s. (med.), m.d., Associate Clinical Pro- 
fessor 
Richard E. Gordon, m.d.. Associate Clinical Professor 
Carl H. Greene, a.b., ph.d., m.d., Associate Clinical Pro- 
fessor 
Edward F. Härtung, a.b., m.d., Associate Clinical Pro- 
fessor 
Max-Wilhelm Johannsen, m.d., Associate Clinical Pro- 
fessor 
S. Edward King, b.s., m.d., m.s.p.h., Associate Clinical 

Professor 
Arnold Koffler, m.d., Associate Clinical Professor 
Lawrence Meyers, b.s., a.m., m.d., Associate Clinical 

Professor 
Jack Nelson, b.s., m.d., Associate Clinical Professor 
Elliot Oppenheim, m.d. [Edinburgh], Associate Clinical 

Professor 
Edward H. Reisner, Jr., a.b., m.d., Associate Clinical 

Professor 
Matthew Shapiro, m.d., Associate Clinical Professor 
Harry A. Solomon, m.d., Associate Clinical Professor 



Saul Solomon, a.b., m.d.,c.m. [mcgill], Associate Clin- 
ical Professor 
Otto Steinbrocker, b.s., m.d., Associate Clinical Professor 
Max Trubek, a.b., m.d., Associate Clinical Professor 
David Ulmar, a.b., m.d., Associate Clinical Professor 
Harry Vesell, a.b., m.d., Associate Clinical Professor 
Michael Weingarten, m.d., Associate Clinical Professor 
Hyman Alexander, b.s., m.d., Assistant Clinical Professor 
Frances L. Bailen-Rose, b.s., m.d., Assistant Clinical Pro- 
fessor 
Z. Taylor Bercovitz, b.s., m.s., ph.d., m.d., Assistant 

Clinical Professor 
Louis F. Bishop, Jr., ph.b., m.d., Assistant Clinical Pro- 
fessor 
Edwin Boros, m.d., Assistant Clinical Professor 
Maurice R. Chassin, a.b., m.d., Assistant Clinical Pro- 
fessor 
Abraham W. Freireich, b.s., m.d., Assistant Clinical 

Professor 
Maxwell L. Gelfand, b.s., m.d., Assistant Clinical Pro- 
fessor 
Samuel U. Greenberg, a.b., m.d., Assistant Clinical Pro- 
fessor 
Frode Jensen, a.b., m.d., Assistant Clinical Professor 
Mennasch Kalkstein, b.s.; m.b.,ch.b. [st. Andrews], As- 
sistant Clinical Professor 
Winifred C. Loughlin, a.b., m.d., Assistant Clinical Pro- 
fessor 
George C. McEachern, a.b., m.d., Assistant Clinical Pro- 
fessor 
Jerome A. Marks, a.b., m.d., Assistant Clinical Professor 
George Pollack, m.d. [London], Assistant Clinical Pro- 
fessor 
Anna R. Spiegelman, a.b., m.d., Assistant Clinical Pro- 
fessor 
John J. Thorpe, b.s., m.d.. Assistant Clinical Professor 
Leo Weiner, b.s.; m.d. [vienna], Assistant Clinical Pro- 
fessor 
William J. Welch, a.b., m.d., Assistant Clinical Professor 
Paul K. Boyer, a.b., m.d., med.sc.d., Instructor 
Irwin R. Cohen, m.d., Instructor 
Joseph Kovacs, a.b., m.d. [Budapest], Instructor 
Teresa McGovern, b.s., m.s., m.d., Instructor 
Lawrence R. Prouty, b.s.(biochem.), m.d., Instructor 
Ralph I. Alford, a.b., m.d., Instructor in Clinical Medi- 
cine 
Michael S. Bruno, a.b., m.d., Instructor in Clinical Medi- 
cine 
Herbert A. Dann, a.b., m.d., Instructor in Clinical Medi- 
cine 
Alfred D. Dennison, Jr., a.b., m.d., Instructor in Clinical 

Medicine 
Helen S. Haskell, a.b., a.m., m.d., Instructor in Clinical 

Medicine 
Jacob Heyman, a.b., m.d., Instructor in Clinical Medicine 
Delavan V. Holman, a.b., m.d., Instructor in Clinical 

Medicine 
Sidney I. Kreps, a.b., m.d., Instructor in Clinical Medi- 
cine 



18 



MEDICINE 



William S. Ling, a.b., m.d., Instructor in Clinical Medi- 
cine 
James Tesler, m.d., m.s. (med.), Instructor in Clinical 

Medicine 
Allan R. Aronson, b.s., m.d., Clinical Instructor 
Shepard G. Aronson, a.b., m.d., Clinical Instructor 
Harry Bartfeld, m.d., Clinical Instructor 
William V. Berger, m.d., Clinical Instructor 
Audrie L. Bobb, a.b., m.s., m.d., Clinical Instructor 
Ralph G. Bonime, b.s., m.d., Clinical Instructor 
Joel J. Brenner, b.s.; a.b., m.b.,ch.b., a.m. [oxon.], Clini- 
cal Instructor 
Leonard B. Burness, B.s., m.d., Clinical Instructor 
ClifTord Cohen, a.b., m.d., Clinical Instructor 
John Staige Davis, Jr., m.d., Clinical Instructor 
Ned Doscher, b.s., m.d., Clinical Instructor 
Alfred Gabel, m.d., Clinical Instructor 
Thomas H. Gleeson, m.d. [Toronto], Clinical Instructor 
Herbert Greenfield, a.b., m.d., Clinical Instructor 
Stanley Isenberg, a.b., m.d., Clinical Instructor 
Mildred E. Kamner, a.b., a.m., ph.d., m.d., Clinical In- 
structor 
Theodore Kaplan, m.d., Clinical Instructor 
Benjamin M. Kaufman, m.d., Clinical Instructor 
Paul Kuhn, m.d., Clinical Instructor 
Harry G. Kupperman, a.b., m.d., Clinical Instructor 
Robert S. Levin, m.d., Clinical Instructor 
Harold J. Livingston, a.b., m.d., Clinical Instructor 
Morton F. Mark, a.b., m.d., Clinical Instructor 
Richard S. Marton, m.d., Clinical Instructor 
Murray L. Maurer, b.s.; m.d. [basel], Clinical Instructor 
Morris O. Pearlmutter, a.b., m.d., Clinical Instructor 
Albert A. Pollack, a.b., m.d., m.s. (med.), Clinical In- 
structor 
Isador Ripps, b.s., m.d., Clinical Instructor 
Dino Sandroni, b.s., m.d., Clinical Instructor 
Philip M. Schulman, b.s., m.d., Clinical Instructor 
M. Stephen Schwartz, a.b., a.m., m.d,, Clinical Instructor 
Myron F. Sesit, a.b., b.s., m.d., Clinical Instructor 
Walter C. Spiess, Jr., m.d., Clinical Instructor 
James M. Tarsy, m.d. [Bologna], Clinical Instructor 
John V. Waller, a.b., m.d., Clinical Instructor 
William Wolins, m.d., Clinical Instructor 
ehester B. Allen, Jr., a.b., m.d., Assistant 
Harry Blutman, m.d., Assistant 
George Bruzza, a.b., m.d., Assistant 
Lisgar B. Eckardt, a.b., a.m., ph.d., m.d., Assistant 



Irving A. Glass, a.b., m.d., Assistant 
Hazel Isenberg, Assistant (Hematology) 
Leopold C. Lazarowitz, m.d. [warsaw], Assistant 
Francis A. Pflum, b.s., m.d., Assistant 
Francis T. Rogliano, b.s., m.d., Assistant 
Sheldon Schwartz, b.s., m.d., Assistant 
Margaret Strauss-Ballard, a.b., m.s., Assistant (Allergy) 
Stanley J. Wittenberg, s.S., m.d., Assistant 
Stewart F. Alexander, a.b., m.d., Clinical Assistant 
Samuel H. Belgorod, a.b., m.d., Clinical Assistant 
Graham L. Bennett, a.b., m.d., Clinical Assistant 
Carlos Bertran, a.b., m.d., Clinical Assistant 
Herbert R. Blain, b.s.; m.d. [Edinburgh], Clinical Assist- 
ant 
Neal S. Bricker, a.b., m.d., Clinical Assistant 
Earl B. Brown, b.s., m.d., Clinical Assistant 
Robert L. Cella, a.b., m.d., Clinical Assistant 
Theodore Cohen, m.d., Clinical Assistant 
Leonard Felder, a.b., m.d., Clinical Assistant 
Benjamin S. Fishman, a.b.; m.d. [london], Clinical 

Assistant 
J. Wilfrid Forster, m.d. [queen's univ., Kingston], Clin- 
ical Assistant 
Morton Glen, a.b., m.d., Clinical Assistant 
Louis W. Granirer, a.b., m.d., Clinical Assistant 
Edwin A. Henck, m.d., Clinical Assistant 
Edwin H. Kaufman, b.s., m.d., Clinical Assistant 
Max S. Königsberg, b.s.; m.d. [Hamburg], Clinical As- 
sistant 
Frederick O. Kraus, b.s., m.d., Clinical Assistant 
Samuel B. Levy, b.s., m.d., Clinical Assistant 
Günther Lomnitz, m.d. [Frankfurt], Clinical Assistant 
John McGaley, m.d., Clinical Assistant 
Louis Mamelok, a.b., m.d., Clinical Assistant 
Richard E. Passenger, b.s., m.d., Clinical Assistant 
Andrew B. Paul, m.d. [Budapest], Clinical Assistant 
Jacob Prager, m.d., Clinical Assistant 
Richard B. Quan, m.d., Clinical Assistant 
Edward H. Roston, a.b., m.d., Clinical Assistant 
Harry Shilkret, b.s., m.d., Clinical Assistant 
Max A. Sklar, b.s., m.d., Clinical Assistant 
William A. Tansey, a.b., m.d., Clinical Assistant 
Arthur R. Thomas, a.b., m.d., Clinical Assistant 
Hobart H. Todd, b.s., m.s., m.d., Clinical Assistant 
Aaron Weiner, m.d. [milan], Clinical Assistant 
John Winslow, a.b., m.d., Clinical Assistant 
Anne B. Wright, a.b., m.d., Clinical Assistant 



5429-A. INTERNAL MEDICINE (GRADUATE 
COURSE) 

A full-time course of one academic or one calendar 
year with daily exercises Mondays through Fridays, 9 
a.m. to 5 p.m., beginning September 29, 1952. (This 
course may be entered July 1, 1952.) The training in 
internal medicine includes special consideration of the 
various subdivisions, such as cardiovascular diseases, 
allergy, metabolic disturbances, pulmonary diseases, 



etc. In addition, the technical disciplines of bacteriol- 
ogy, biochemistry, physiology, pathology, and phar- 
macology are elaborated in relation to clinical 
medicine. Students come in contact with patients on 
the medical Services of Bellevue Hospital, University 
Hospital, and Willard Parker Hospital (Tuberculosis 
Division ) . They participate in Conferences, seminars, 
and other forms of instruction. Assignments are also 
made to the various specialty clinics in Bellevue Hos- 
pital. Problems pertaining to the medical sciences as 



19 






MEDICINE 



applied to clinical medicine are developed under the 
guidance of a member of the department of medicine 
and in conjunction with other departments according 
to the nature of the problem. Through the various 
clinical facilities enlarged experience is made available 
particularly in the practical matters of diagnosis and 
treatment. 

Given under the direction of Professor Charles F. 
Wilkinson, Jr. Tuition $700.00. 

541-A. SEMINAR IN INTERNAL MEDICINE 
A fuU-time, eight weeks* course, April 13 through 
June 5, 1953, consisting of a survey of the field of 
internal medicine by means of lectures and case dem- 
onstrations in the various medical specialties. The 
program is composed of the part-time courses 542-A, 
543-A, 544-A, 544-B, 545-A, 546-B, 547-A, 548-A, 
549-A, 5410-A, 541 1-A, 5412-A, 5413-A (de- 
scribed below), weekly one-hour lectures on an 
evaluation of modern therapeutics, and weekly staff 
Conferences. 

Given under the direction of Professor Charles F. 
Wilkinson, Jr. Maximum class 20. Tuition $250.00. 

542-A. ARTHRITIS AND ALLIED RHEU- 
MATIC DISORDERS 

A part-time course of eight sessions, 9 a.m. to 12 
m., Tuesdays, April 14 through June 2, 1953, consist- 
ing of a systematic survey of arthritis and rheumatic 
diseases. Special attention is given to current diagnos- 
tic procedures and advances in therapy. 

Given under the direction of Dr. Edward F. Här- 
tung. Tuition $50.00. 

543-A. ALLERGY 

A part-time course of eight sessions, 2 to 4 p.m., 
Fridays, April 17 through June 5, 1953. Consists of a 
discussion of the fundamentals of allergy together 
with a description of the diagnosis and treatment of its 
various clinical forms, combined with the demonstra- 
tion of cases. 

Given under the direction of Dr. W. C. Spain. Tui- 
tion $40.00. 

544-A. CARDIOLOGY 

A part-time course of eight sessions, 2 to 5 p.m., 
Thursdays, April 16 through June 4, 1953. 

Designed as a review course for physicians doing 
general practice or internal medicine. As far as pos- 
sible, emphasis is placed on clinical cardiology and 
an attempt is made to review all the major forms of 
heart disease with discussion of modern trends in 



treatment and demonstration of patients. Many teach- 
ing aids are used such as the electron vectroscope (see 
page 63) with stethoscopic amplification and the 
fluoro-demonstrator. The former Instrument enables 
each member of the class to listen to each patient and 
at the same time to see the simultaneous electrocardio- 
gram or stethogram of the patient. The fluoro-demon- 
strator is an apparatus for teaching large groups the 
fundamentals of cardiac fluoroscopy without some of 
the drawbacks of the darkroom. This equipment, 
designed exclusively for teaching, has been developed 
in this laboratory. 

Given under the direction of Drs. Charles A. 
Poindexter and J. Scott Butterworth. Maximum class 
40. Tuition $75.00. 
544-B. CLINICAL ELECTROCARDIOGRAPHY 

A part-time course of eight sessions, 12:30 to 2 
p.m., Thursdays, April 16 through June 4, 1953, deal- 
ing with modern electrocardiography and stressing the 
basic electrophysiology of the heart rather than pat- 
tern diagnosis. Extremity potentials, unipolar leads, 
and esophageal leads are fully covered. An introduc- 
tion to vectrocardiography is also included. The elec- 
tron vectroscope is frequently used (see page 63) 
rather than placing too much emphasis on slides. 

Given under the direction of Dr. Charles A. Poin- 
dexter. Tuition $40.00. 

545-A. NORMAL AND PATHOLOGICAL 
PHYSIOLOGY: FUNCTION AL AND CHEMI- 
CAL ASPECTS 

A part-time course of eight sessions, 9 to 11 a.m., 
Wednesdays, April 15 through June 3, 1953. A lec- 
ture course presenting a rapid review of the normal 
and pathological physiology of those Systems of par- 
ticular importance in internal medicine. The clinical 
value, indications, and interpretations of functional 
and Chemical tests designed to reveal disturbed physi- 
ology are discussed. Does not include actual demon- 
strations of chemical technique but the importance of 
laboratory data in diagnosis is stressed. 

Given under the direction of Dr. Maurice Bruger. 
Tuition $40.00. 

546-A. CLINICAL HEMATOLOGY 

A part-time course of ten sessions, 9 to 11 a.m., 
Mondays, October 6 through December 8, 1952. 
Consists of a discussion of the techniques used in 
hematology, with the Interpretation of hematological 
laboratory data. The pathogenesis, symptomatology, 
and treatment of the anemias, polycythemia, disorders 
of the white cells, spieen and lymph nodes, and the 



20 



MEDICINE 



hemorrhagic diatheses are reviewed. The use of folic 
acid, Vitamin B12, nitrogen mustards, radioactive 
phosphorus, urethane, folic-acid antagonists, and 
pituitary and adrenal hormones is considered, as well 
as the use of blood and blood Substitutes and the clini- 
cal importance of the Rh factor. 

Given under the direction of Dr. Edward H. Reis- 
ner, Jr. Tuition $40.00. 

This course is repeated as 546-B, in sixteen ses- 
sions, 12 m. to 1 p.m., Tuesdays and 9 a.m. to 10:30 
a.m., Thursdays, April 14 through June 4, 1953. 

547-A. PROBLEMS IN DIAGNOSIS 

A part-time course of eight sessions, 9 to 11:45 
a.m., Mondays, April 13 through June 1, 1953, con- 
sisting of case teaching with special emphasis on dis- 
ease Seen in office and hospital practice. The history, 
interpretation of physical findings, X-ray, and labora- 
tory analyses are included in the discussion of differ- 
ential diagnosis. A part of each Session is devoted to 
the examination of patients by the matriculates. 

Given under the direction of Dr. Matthew Shapiro. 
Maximum class 20. Tuition $35.00. 

548-A. ACUTE AND CHRONIC DISEASES OF 
THE CHEST 

A part-time course of eight sessions, 2 to 4 p.m., 
Mondays, April 13 through June 1, 1953, consisting 
of diagnosis and treatment, practical discussion and 
demonstration of acute and chronic pulmonary dis- 
eases, correlation of X-ray findings with clinical stud- 
ies, and fluoroscopy. 

Given under the direction of Dr. David Ulmar. 
Maximum class 20. Tuition $35.00. 

549-A. ENDOCRINOLOGY 

A part-time course of twenty-four sessions, Mon- 
days, 12 m. to 1 p.m., Thursdays, 10:30 to 11:30 
a.m., and Fridays, 9 to 10 a.m., April 13 through June 
5, 1953. Surveys the fields of endocrinology and Cov- 
ers a comprehensive review of the recent develop- 
ments in the diagnosis and treatment of diseases of the 
thyroid, parathyroid, adrenal, pituitary, gonads, and 
the everyday and emergency management of the dia- 
betic patient. 

Given under the direction of Dr. Benjamin I. Ashe, 
assisted by the staff. Tuition $40.00. 

5410-A. DISEASES OF THE LIVER AND BILI- 
ARY TRAGT 

A part-time course of eight sessions, 1 1 a.m. to 1 
p.m., Wednesdays, April 15 through June 3, 1953, 



consisting of recent advances in the diagnosis and 
medical management of functional and organic disor- 
ders of the liver and biliary tract; technique and Inter- 
pretation of biliary drainage; pancreatic function 
tests; liver function tests; surgical indications. 

Given under the direction of Dr. J. Russell Twiss. 
Tuition $35.00. 

541 1-A. GASTROENTEROLOGY 

A part-time course of eight sessions, 2 to 5 p.m., 
Wednesdays, April 15 through June 3, 1953, consist- 
ing of diagnosis and treatment of diseases of the 
esophagus and stomach, with particular attention to 
peptic ulcer; gastroscopic examinations; diseases of 
the large and small intestines, with particular attention 
to ulcerative Colitis; sigmoidoscopic examinations; 
correlation of X-ray findings with clinical studies. 

Given under the direction of Dr. Clarence C. Füller. 
Tuition $40.00. 

5412-A. NEPHRITIS AND HYPERTENSION 

A part-time course of eight sessions, 9 a.m. to 1 
p.m., Fridays, April 17 through June 5, 1953. A com- 
prehensive but concise presentation of recent develop- 
ments and current concepts in the diagnosis and 
treatment of the nephritides and vascular hyperten- 
sion. Basic pathologic physiology is applied to the 
management of clinical problems. Biochemical and 
body electrolytic disturbances in renal disease are con- 
sidered in relation to actual therapeutic problems. A 
demonstration and discussion of hemodialysis (artifi- 
cial kidney) in the treatment of anuria is included. 
The relationships of the various specialties to hyper- 
tension and nephritis are discussed by the individual 
departments in an informal clinical review. 

Given under the direction of Dr. S. Edward King. 
Tuition $30.00. 

5413-A. PERIPHERAL VASCULAR DISEASES 

A part-time course of eight sessions, 2 to 4 p.m., 
Tuesdays, April 14 through June 2, 1953. Consists of 
the use and interpretation of methods of diagnosis and 
treatment of diseases of the vascular System, including 
thromboangiitis obliterans, Raynaud's disease, and 
arteriosclerosis. 

Given under the direction of Dr. A. Wilbur Duryee. 
Maximum class 30. Tuition $40.00. 

5414-A. ARTHRITIS AND ALLIED RHEU- 
MATIC DISORDERS 

A full-time course of two weeks' duration, July 7 
through 18, 1952. The first week Covers the funda- 
mental concepts of anatomy, physiology, and path- 



21 



MEDICINE 



ology necessary for a basic understanding of the 
subject, together with a detailed exposition of the main 
disease entities and their treatment, including rheuma- 
toid arthritis, Osteoarthritis, specific infectional arthn- 
tis, gout, acute rheumatic fever, and fibrositis. The 
second week affords a survey of the most recent 
advances in this field, and to this end the staflf of the 
entire Center has been drawn upon Uberally. During 
the entire two-week period the Student has actual con- 
tact with the arthritic patient and observes and partici- 
pates in all forms of therapy. 

Given under the direction of Dr. Edward F. Här- 
tung. Tuition $125.00. 

This course is repeated as 5414-B, November 10 
through 21, 1952. (To be offered in July 1953 also.) 

5415-A. ALLERG Y 

A full-time course of two weeks' duration, Novem- 
ber 10 through 21, 1952, consisting of morning 
sessions devoted to laboratory instruction in the 
preparation and standardization of protein extracts, 
while afternoon sessions in the large outpatient clinic 
deal with the diagnosis and treatment of asthma, hay 
fever, and other allergic diseases, the technique of skin 
tests and hyposensitization, and the role of focal infec- 
tions in allergy. 

Given under the direction of Dr. W. C. Spain. 
Maximum class 12. Tuition $200.00. 

This course is repeated as 5415-B, March 16 
through 27, 1953. 

54 1 6-A. ACUTE AND CHRONIC PULMONARY 
DISEASES 

A full-time course of five days' duration, March 9 
through 13, 1953, consisting of diagnosis and treat- 
ment; practical discussion and demonstration of acute 
and chronic pulmonary diseases; correlation of X-ray 
findings with clinical studies; fluoroscopy. Lectures 
and bedside teaching. 

Given under the direction of Dr. David Ulmar. 
Maximum class 15. Tuition $45.00. 

5418-A. PERIPHERAL VASCULAR DISEASES 
A full-time course of five days' duration, November 
17 through 21, 1952, consisting of differential diag- 
nosis; the use and Interpretation of diagnostic methods 
including the oscillometer, nerve block, hot-water 
Immersion tests and surface-temperature studies, 
arteriography; the medical and surgical treatment of 
diseases of the peripheral vascular system including 
thromboangiitis obliterans, Raynaud's disease, sclero- 
derma, and arteriosclerosis; venous and lymphatic 



pathology; surgical aspects of vascular diseases; and 
demonstration of apparatus. Case studies are stressed 
throughout the course. 

Given under the direction of Dr. A. Wilbur Duryee. 
Maximum class 30. Tuition $50.00. 

This course is repeated as 541 8-B, June 22 through 
26, 1953. 

541 9-A. SYMPOSIUM ON INTERNAL MEDI- 
CINE 

A full-time course of ten days' duration, June 15 
through 26, 1953. Registrations are accepted for the 
entire ten days or for either the first or second five-day 

period. 

Offers the Internist and general practitioner a con- 
cise review of present-day therapy in the field of inter- 
nal medicine. Indications and contraindications in the 
use of the newer drugs are discussed. Presentations 
include the following topics: cardiovascular disease, 
antibiotics, hematology, arthritis, hypertension, nutri- 
tion, diabetes, renal disease, gastroenterology, and 
endocrinology. Lectures are given on the present 
Status of radioactive isotopes in the treatment of 
malignant disease, fluid balance in health and disease, 
and the newer antihistamine drugs in allergic diseases. 

Given under the direction of Professor Charles F. 
Wilkinson, Jr. Tuition for five days $50.00; ten days 
$90.00. 

5420-A. NORMAL AND PATHOLOGICAL 
PHYSIOLOGY: FUNCTION AL AND CHEMI- 
CAL ASPECTS 

A full-time course of ten days' duration, September 

22 through October 3, 1952. A lecture course pre- 

sented as a review of normal and pathological physi- 

ology of those Systems of particular importance in 

internal medicine. Discussions include fat, protein, 

and carbohydrate metabolism, respiratory physiology, 

hematopoietic system, the vitamins, bile physiology, 

the functional testing of the stomach, pancreas and 

liver, the endocrine glands, Phosphatase metabolism, 

cerebrospinal fluid chemistry, mineral metabolism, 

cardiac physiology, blood volume, water balance, and 

acid-base metabolism. The clinical value, indications, 

and Interpretation of functional and chemical tests 

designed to reveal disturbed physiology are discussed. 

Does not include actual demonstrations of chemical 

technique but the importance of laboratory data in 

diagnosis is stressed. 

Given under the direction of Dr. Maurice Bruger. 
Tuition $100.00. 

This course is repeated as 5420-B, February 23 
through March 6, 1953. 



MEDICINE 



542 1-A. GASTROENTEROLOGY 

A full-time course of five days' duration, October 
13 through 17, 1952, covering diseases of the esopha- 
gus, stomach, rectum, liver, biliary tract, and 
pancreas, with special reference to diagnosis and 
treatment. Gastroscopy, sigmoidoscopy, and duode- 
nal drainage are demonstrated and their significance 
discussed. The newer methods of treatment are 
presented. 

Given under the direction of Dr. Clarence C. Füller. 
Maximum class 40. Tuition $45.00. 

This course is repeated as 542 1-B, June 15 through 
19, 1953. 

5422-A. ENDOCRINOLOGY 

A full-time course of five days' duration, July 21 
through 25, 1952. Surveys the field of endocrinology 
and Covers a comprehensive review of the recent 
developments in the diagnosis and treatment of dis- 
eases of the thyroid, parathyroid, adrenal, pituitary, 
gonads, and the everyday and emergency management 
of the diabetic patient. These are discussed under the 
headings: the detection of diabetes and its differential 
diagnosis, the objectives to be attained by therapy, the 
criteria for good control, the use of diets and how 
much can be accomplished by their use, when and how 
to use the various types of insulin, the management of 
emergencies including ketosis and coma, the detection 
and management of hypoglycemia, and complications 
and intercurrent problems in the course of diabetes 
and their management by modern methods. 

Disorders of the thyroid gland are discussed along 
the following lines: diagnostic laboratory procedures, 
such as protein-bound iodine, radioactive iodine 
uptake, and basal metabolism; diagnosis and treat- 
ment of toxic goiter; diagnosis and treatment of hypo- 
thyroidism; selection of cases for surgery, the types 
and incidence of complications following thyroidec- 
tomy. 

The course considers the other glands of internal 
secretion— the pituitary, the adrenals, parathyroids, 
ovaries, and testes and includes a discussion of the 
hormones, their physiology, the more important clini- 
cal Syndromes, and their diagnosis and treatment. 

Given under the direction of Dr. Benjamin I. Ashe, 
assisted by the staff. Tuition $50.00. 

This course is repeated as 5422-B, November 10 
through 14, 1952. (To be offered in July 1953 also.) 

5423-A. ELECTROCARDIOGRAPHY 

A full-time course of five days' duration, Novem- 
ber 17 through 21, 1952, dealing with modern 



electrocardiography and stressing the basic electro- 
physiology of the heart rather than pattern diagnosis. 
Extremity potentials, unipolar and esophageal leads 
are fully covered. An introduction to vectrocardi- 
ography will also be included. The electron vectro- 
scope is used (see page 63). 

Given under the direction of Dr. Charles A. Poin- 
dexter. Tuition $75.00. 

This course is repeated as 5423-B, March 30 
through April 3, 1953. 

5424-A. NEPHRITIS AND HYPERTENSION 

A five-day, full-time course, July 14 through 18, 
1952. A comprehensive review of recent develop- 
ments in renal diseases and vascular hypertension. 
Essential physiologic advances, including renal clear- 
ance methods and electrolytic disturbances in renal 
disease, are presented. A demonstration of hemodialy- 
sis (artificial kidney) is given. Most types of renal dis- 
ease, including glomerular nephritis, the nephroses, 
acute renal insufticiency (lower nephron nephritis), 
Pyelonephritis, and renal vascular lesions associated 
with pregnancy, are covered. 

Psychiatric, endocrine, and urologic factors in 
hypertension are considered, as well as cardiac, cere- 
bral, and renal complications. The general manage- 
ment of hypertension, including the indications for 
sympathectomy is reviewed. Major emphasis through- 
out is placed upon practical clinical methods of diag- 
nosis and treatment. 

Members of the departments of surgery, urology, 
psychiatry and neurology, and ophthalmology present 
the various specialties in their relationship to renal 
and hypertensive vascular disease. Lectures are sup- 
plemented by demonstrations, ward-case presenta- 
tions, and round-table Conferences. 

Given under the direction of Dr. S. Edward King. 
Tuition $50.00. 

This course is repeated as 5424-B, October 27 
through 31, 1952. (To be offered in July 1953 also.) 

5425-A. CARDIOLOGY 

A full-time, four weeks' comprehensive course, 
June 29 through July 24, 1953. An attempt is made to 
summarize the basic knowledge and the recent ad- 
vances in cardiology in regard to diagnosis and treat- 
ment. Electrocardiography is an integral part of the 
course and emphasis is placed on the modern electro- 
physiology of the heart. Subjects such as extremity 
Potentials, esophageal leads, unipolar leads, and 
exploratory leads are fully discussed, and the electron 
vectroscope is used to demonstrate to the entire group 
electrocardiograms from test subjects and patients. 



22 



23 



tili ImiS^^''^-^^ ..--.— .^m^^^m 



MEDICINE 



Auscultation of the heart is studied under ideal condi- 
tions by use of the electronic stethoscope whereby 
each Student and the instructors listen at the same time 
to each patient through individual electronic stetho- 
scopes. The electrocardiogram or stethogram of the 
patient can be visualized on the electron vectroscope 
at the same time. The fluoro-demonstrator is available 
for the teaching of cardiac fluoroscopy. The electron 
vectroscope (see page 63), the multiple electronic 
stethoscopes, the fluoro-demonstrator, and other de- 
vices have all been developed in this laboratory to 
improve the teaching of cardiology by audio-visual 
methods. 

Given under the direction of Drs. Charles A. 
Poindexter and J. Scott Butterworth. Maximum class 
40. Tuition $250.00. 

5426-A. GERIATRICS 

A three-day, fuU-time course, January 28, 29, and 
30, 1953, designed to familiarize physicians with the 
broader aspects of the care of elderly patients. It is 
realized that geriatrics is not a true specialty and, 
therefore, the subject matter is presented from a point 

The Electron Vectroscope Visuolly Records the Sound» of the Living Heart 



of view that encompasses the medical and surgical 
subspecialties as well as the psychosomatic and reha- 
bilitation aspects. Emphasis is placed on the diagnosis 
and treatment of diseases commonly associated with 
aging as well as the altered physiological and meta- 
bolic conditions found in this older group. 

Given under the direction of Professor Charles F. 
Wilkinson, Jr. Tuition $30.00. 

5427-A. AUSCULTATION OF THE HEART 

A three-day, full-time course, September 8 through 
10, 1952, designed to stress the types of heart disease 
where important findings are present on physical diag- 
nosis and to present auscultatory findings. Numerous 
audio-visual aids have been developed in the labora- 
tory which are particularly useful in the teaching of 
auscultation. These include the electron vectroscope 
(see page 63 ) , and the use of tape recordings for illus- 
trating unusual sounds. 

Given under the direction of Dr. J. Scott Butter- 
worth. Tuition $50.00. 

This course is repeated as 5427-B, February 2 
through 4, 1953. 




Ja 



^^ ^ ji 



1^ 




MEDICINE 



5428-A. INTERNAL MEDICINE 

Instruction is given five momings a week, March 2 
through 27, 1953, for four weeks. Designed for physi- 
cians in general practice who wish a practical review 
of recent advances in diagnosis and treatment. 
Instruction is given to small groups at the bedside by a 
member of the staff, usually a specialist in the field 
which is the subject of discussion. Once each week 
members of the course attend a clinical pathological 
Conference. 

Given under the direction of Dr. Charles H. Nam- 
mack. Maximum class 12. Tuition $100.00. 

5430-A. REVIEW COURSE IN GENERAL 
MEDICINE 

A full-time course of ten days' duration, Mondays 
through Fridays, July 14 through 25, 1952, making a 
total of sixty hours of instruction. Designed especially 
for members of the American Academy of General 
Practice but other physicians are eligible to attend. It 
includes the main features of internal medicine and its 
subdivisions, as well as dermatology and syphilology, 



pediatrics, neuropsychiatry, physical medicine, and 
the diagnosis and pre- and postoperative care of surgi- 
cal conditions. Instruction is given in Bellevue Hospi- 
tal by means of ward rounds, Conferences, seminars, 
and clinics. 

Given under the direction of Professor Charles F. 
Wilkinson, Jr. Maximum class 50. Tuition $100.00. 
(To be offered in July 1953 also.) 

543 1-A. ACTH AND CORTISONE 

A full-time course of three days' duration, February 
18, 19, and 20, 1953. An intensive discussion course 
in the use and relationship of ACTH, Cortisone, and 
other adrenal Steroids to many of the phases of medi- 
cine, making use of the clinical facilities of the Medi- 
cal Center. 

Given under the direction of Professor Charles F. 
Wilkinson, Jr. Tuition $35.00. 

5432-A. PULMONARY DISEASES IN RELA- 
TION TO INDUSTRY 

A full-time course of five days' duration, May 18 
through 22, 1953, for the purpose of giving the 

Bedside Teaching Is Constantly Emphasized 



f 



*M 






1 




■fL 



%,. 




MEDICINE 



matriculate a practical approach to the problems of 
industry in relation to thoracic disease. To this end, a 
brief background of pathology and physiology is the 
basis for the presentations on the various illnesses and 
occupational diseases that are encountered. Emphasis 
is placed on treatment and rehabiiitation, problems of 
extreme importance to the industrial physician. Some 
of the legal aspects of compensable disease are 
touched. Ample opportunity is presented for forum 
discussion. 

Given under the direction of Dr. David Ulmar. Tui- 
tion $50.00. 

5433-A. FLUOROSCOPY OF THE HEART 

A two-day, full-time course, September 1 1 and 12, 
1952, dealing primarily with examination of the heart 
by fluoroscopic methods. The techniques of making 
accurate orthodiagrams are described and illustrated. 
Various types of Chamber abnormalities are discussed 
and, in addition, procedures such as roentgenkymog- 
raphy, electrokymography, and angiocardiography 
are given special attention. For a description of some 
of the equipment used in this course, see the special 
section on audio-visual aids (page 63). 

Given under the direction of Drs. Charles A. 
Poindexter and J. Scott Butterworth. Tuition $30.00. 

This course is repeated as 5433-B, February 5 and 
6, 1953. 

5434-A. CONGENITAL HEART DISEASE 

A three-day, fuli-time course, October 6 through 8, 
1952, designed to give a survey of congenital heart 
disease. It takes up the common and some of the more 
unusual types of congenital cardiac malformations 
and includes discussions and illustrations of the vari- 
ous types of procedures used in arriving at diagnosis. 
These procedures include cardiac catheterization with 
pressure readings, oxygen Contents, studies, and elec- 
trocardiograms from inside the heart as well as angio- 
cardiography. For a description of some of the 
equipment used in this course, see the special section 
on audio-visual aids (page 63). 

Given under the direction of Dr. Charles A. Poin- 
dexter. Tuition $40.00. 



26 



5435-A. RHEUMATIC HEART DISEASE 

A three-day, full-time course, October 27 through 
29, 1952, organized to give a general review of rheu- 
matic heart disease with emphasis on the newer meth- 
ods of diagnosis and therapy. All types of rheumatic 
lesions from acute rheumatic fever to the end result of 
rheumatic valvulär disease are discussed. For a 
description of some of the special equipment used in 
this course, see the section on audio-visual aids (page 
63). 

Given under the direction of Dr. Charles A. Poin- 
dexter. Tuition $40.00. 

5436-A. DEGENERATIVE HEART DISEASE 

A three-day, full-time course, January 12 through 
14, 1953. Concerning degenerative heart disease in 
general, the material consists of diseases of a degen- 
erative nature which affect the coronary arteries and 
the myocardium. This includes arteriosclerosis of the 
coronary vessels and hypertensive heart disease. Spe- 
cial attention is given to more recent concepts of diag- 
nosis and treatment of the degenerative diseases. For 
a description of the special methods used in teaching, 
see the section on audio-visual aids (page 63). 

Given under the direction of Dr. Charles A. Poin- 
dexter. Tuition $40.00 



740-A. COMPREHENSIVE MEDICINE FOR 
FOREIGN PHYSICIANS 

One academic year of full-time study, Mondays 
through Fridays from 9 a.m. to 5 p.m., September 29, 
1952, through June 19, 1953. A comprehensive course 
in American medicine for graduates of foreign medi- 
cal schools desiring to practice in this country. Condi- 
tional admission to the examinations of one of the 
State or National Boards of Medical Examiners is a 
prereqidsite for admission. (All departments partici- 
pate in this course.) Further information may be 
obtained from the Office of the Dean, Post-Graduate 
Medical School, 477 First Avenue, New York 16, 
N.Y. 



MICROBIOLOGY 



MICROBIOLOGY 



College of Medicine 



Colin M. MacLeod, m.d.,c.m. [mcgill], Professor and 

Chairman of the Department 
Alwin M. Pappenheimer, Jr., b.s., ph.d., Professor 
Mark H. Adams, a.b., ph.d., Associate Professor 
James E. Ziegler, Jr., a.b., m.d., Associate Professor 
Alan W. Bernheimer, B.s., a.m., ph.d., Assistant Professor 



432-A. VIRUSES AND VIRUS DISEASES 

A full-time course of seven weeks' duration, 9 a.m. 
to 5 p.m., Mondays through Fridays, March 23 
through May 9, 1953. Half of the time devoted to lab- 
oratory exercises, the remainder to lectures, Seminars, 
and Conferences. No other work should be undertaken 
as it is anticipated that the füll time of the Student will 
be occupied by this course. Designed to acquaint 



L. Royal Christensen, B.s., ph.d.. Assistant Professor 
Efraim Racker, m.d. [vienna], Assistant Professor 
NormaC. Styron, a.b., b.s., m.s., Instructor 
Benjamin Mandel, B.s., m.s., ph.d., Assistant 
Walter L. Barksdale, Fellow 
Odd A. Wager, m.d. [helsinkiI, Fellow 



advanced students with techniques currently used in 
virus research and with recent advances in our knowl- 
edge of virus infections, using both bacterial and ani- 
mal viruses as illustrative materials. Prerequisite: a 
working knowledge of bacteriological techniques. 
Further details may be obtained on request. 

Given under the direction of Professor Colin M. 
MacLeod. Maximum class 16. Tuition $21 1.00. 

A Modern Microbiology Laboratory 



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NEUROSURGERY 



OBSTETRICS AND GYNECOLOGY 



NEUROSURGERY 



OBSTETRICS AND GYNECOLOGY 



Thomas I. Hoen, a.b.. m.d., Professor and Chairman of 
the Department 

Francis A. Echlin, m.d.,c.m. [mcgill]; med.sc.d.; m.sc. 
[mcgill], Associate Professor 

James T. Daniels, m.d., Associate Professor of Clinical 
Neurosurgery 

Irving S. Cooper, a.b., m.d., m.s., ph.d., Assistant Pro- 
fessor 



551-A. THE INTERVERTEBRAL DISO 

A full-time course of five days' duration, October 6 
through 10, 1952. An intensive study of the problems 
of intervertebral disc disease. Consists of lectures, 
clinical, pathological, and X-ray demonstrations. For 
qualified neuro-, general, and orthopedic surgeons. 

Given under the direction of Professor Thomas I. 
Hoen. Maximum class 10. Tuition $60.00. 

552-A. DIAGNOSIS AND TREATMENT OF 
PERIPHERAL NERVE INJURIES 

A full-time course of five days' duration, January 
12 through 16, 1953. Lectures, case presentations, 
and study of pathologic material, including demon- 



Stanley Stellar, a.b., m.d., Assistant Professor 

Thomas Q. Garvey, Jr., b.s., m.d., Assistant Professor of 
Clinical Neurosurgery 

J. Arthur MacLean, m.d., Assistant Professor of Clinical 
Neurosurgery 

Leo M. Davidoflf, m.d., Clinical Professor 

Carlos Guillermo de Gutierrez-Mahoney, a.b., m.d., Clin- 
ical Professor 



stration and Instruction in electrodiagnostic methods. 
Surgical treatment is given in considerable detail with 
demonstrations in animals, and clinical material if 

available. 

Given under the direction of Professor Thomas I. 
Hoen. Maximum class 10. Tuition $90.00. 

553-A. TRAUMA OF CENTRAL NERVOUS 
SYSTEM 

A full-time course of six days' duration, June 15 
through 20, 1953, for general surgeons. Consists of 
lectures, presentation of pathologic material, clinical 
Conferences, and attendance at Operations. 

Given under the direction of Professor Thomas I. 
Hoen. Maximum class 15. Tuition $75.00. 



28 



Professor and Chairman of Department (to be an- 

nounced) 
Locke L. Mackenzie, a.b., m.d., Associate Professor 
Mortimer N. Hyams, m.d., Associate Professor of Clin- 
ical Obstetrics and Gynecology 
Michael J. Jordan, b.s., m.d., Associate Professor of 

Clinical Obstetrics and Gynecology 
Theodore Neustaedter, m.d., Associate Professor of Clin- 
ical Obstetrics and Gynecology 
E. Lawrence Hecht, b.s., m.d., Assistant Professor of 

Clinical Obstetrics and Gynecology 
Henry C. Falk, m.d., Clinical Professor 
Salvatore di Palma, m.d., Associate Clinical Professor 
Adolph Jacoby, m.d., Associate Clinical Professor 
Isador W. Kahn, m.d., Associate Clinical Professor 
John A. Kelly, m.d., Associate Clinical Professor 
Gerard L. Moench, m.d., Associate Clinical Professor 
Benjamin Rabbiner, m.d., Associate Clinical Professor 
Samuel Schmerzler, m.d., Associate Clinical Professor 
Joseph N. Tesi, m.d. [florence], Associate Clinical Pro- 
fessor 
George Blinick, b.s., m.d., Assistant Clinical Professor 
Matthew Di Giorgi, m.d., Assistant Clinical Professor 
Emanuel M. Wainess, m.d., Assistant Clinical Professor 
Ben B. Wetchler, b.s., m.d., m.s., Assistant Clinical Pro- 
fessor 
Martin J. Clyman, b.s., m.d., Instructor 
Benedict B. Benigno, B.s. (biolggy), m.d., Instructor in 

Clinical Obstetrics and Gynecology 
John C. DuBois, a.b., m.d., Instructor in Clinical Obstet- 
rics and Gynecology 
G. Thurman Fulmer, b.s., m.d., Instructor in Clinical 

Obstetrics and Gynecology 
Louis Gordon, m.d., Instructor in Clinical Obstetrics and 

Gynecology 
Morton K. Hertz, m.d., Instructor in Clinical Obstetrics 

and Gynecology 
Peter La Mariana, B.s., m.d., Instructor in Clinical Obstet- 
rics and Gynecology 

560-A. GYNECOLOGICAL MALIGNANCY 

A full-time ten-day course, October 1 3 through 24, 
1952. Designed for specialists in obstetrics and gyne- 
cology only. The anatomy of the female pelvis is dis- 
cussed with particular attention to considerations 
affecting the spread of malignant disease, including 
lectures on embryology and pathology, as well as lec- 
tures and laboratory werk on exfoliative cytology in 
the diagnosis of the malignancy. The newer chemical 
tests for Carcinoma are discussed; the diagnosis, diflfer- 
ential diagnosis, and treatment, both surgical and by 
radioactive energy. It also includes a discussion of the 
fundamental concepts of radiant energy, the atomic 
structure of matter, and the interreaction of radiant 



John Messina, m.d. [naples], Instructor in Clinical Ob- 
stetrics and Gynecology 

Ernest Myller, m.d. [berlin; Athens], Instructor in Clin- 
ical Obstetrics and Gynecology 

Gottfried Neumann, m.d. [Leipzig], Instructor in Clinical 
Obstetrics and Gynecology 

Anna Earl Purdy, a.b., m.d., Instructor in Clinical Ob- 
stetrics and Gynecology 

Maxwell Schräm, b.s. (med.), m.d., Instructor in Clinical 

Obstetrics and Gynecology 
Ethel Torten Sokal, m.d. [lwow], Instructor in Clinical 

Obstetrics and Gynecology 

Anna A. Stein, m.d., Instructor in Clinical Obstetrics and 
Gynecology 

David L. Bobker, b.s., Clinical Instructor 
Robert M. Cushing, b.s., m.d,, Clinical Instructor 
Jacob Donshik, b.s., m.d., Clinical Instructor 
Phyllis DeVit Gallaher, m.d., Clinical Instructor 
Stefano Miele, m.d. [naples], Clinical Instructor 
Milton H. Miller, m.d., Clinical Instructor 
Charles R. Moog, b.s., m.d., Clinical Instructor 
John E. O'Connor, a.b., m.d., Clinical Instructor 
William B. Quinn, b.s., m.d., Clinical Instructor 
Samuel Ratowsky, b.s., m.d., Clinical Instructor 
Nathan E. Ross, b.s., m.d., Clinical Instructor 
Herbert Z. Teichner, m.d. [naples], Clinical Instructor 
Alfred Widetsky, b.s., m.d., Clinical Instructor 
Frederick S. Kinder, a.b., m.d., Assistant 
Robert H. Berman, ph.b., m.d., Clinical Assistant 
Morris I. Eisenstein, m.d., Clinical Assistant 
Charles H. Immordino, b.s., m.d., Clinical Assistant 

Helen Z. Jern, physician [moscovv], a.m., Clinical As- 
sistant 

Edward R. Laus, m.d.. Clinical Assistant 
Maxwell Roland, a.b., m.d. [lwsanne], Clinical Assistant 
Raymond W. Sass, b.s., m.d., Clinical Assistant 
Feliciano J. Scire, m.d. [naples], Clinical Assistant 

energy with tissue, both physical and biological, and 
it Covers practica] considerations and dosage in X-ray 
and radium therapy. The diagnosis and surgery of 
Carcinoma of the breast as well as urological complica- 
tions are covered also. 

Given under the direction of Dr. Locke L. Mac- 
kenzie. Tuition $150.00. 

561-A. SEMINAR IN GYNECOLOGY 

A full-time course of four weeks' duration, October 
6 through November 1, 1952. Clinical lectures (illus- 
trated with lantern slides, anatomical specimens, and 
motion pictures), clinics, and ward rounds provide 
systematic Instruction in gynecological pathology, 
diagnosis and office treatment, cystoscopy and endo- 



29 



OBSTETRICS AND GYNECQLOGY 



OBSTETRICS AND GYNECOLOGY 



scopy, vaginal and endometrial cytology, and gyne- 
cological endocrinology. 

Given under the direction of Professor Emeritus 
Walter T. Dannreuther. Maximum class 6. Tuition 

$150.00. 

This course is repeated as 561-B, April 13 through 

May 9, 1953. 

562-A. GYNECOLOGY: DIAGNOSIS AND OF- 
FICE TREATMENT 

A part-time course of ten sessions, 10 a.m. to 12 
m., Mondays, Wednesdays, and Fridays, October 27 
through November 17, 1952. 

Given under the direction of Dr. Matthew 
Di Giorgi. Maximum class 6. Tuition $50.00. 

This course is repeated as 562-B, February 23 
through March 16, 1953. 

563-A. GYNECOLOGY: DIAGNOSIS AND OF- 
FICE TREATMENT 

A part-time course of fifteen sessions, 2 to 4 p.m., 
Mondays, Wednesdays, and Fridays, September 15 
through October 17, 1952. 

Given under the direction of Dr. Mortimer N. 
Hyams. Maximum class 6. Tuition $75.00. 

This course is repeated as 563-B, March 23 
through April 24, 1953. 

Both of the above courses are presented by demon- 
strations, lantern slides, and practical application. 
Opportunity is given to examine a large number of 
patients and to develop diagnostic ability. Course 563 
also includes electrotherapy as it applies to gynecol- 
ogy, methods of conization of the uterine cervix, 
uterosalpingography, sterilization by coagulation of 
the uterine cornu, and transuterine insufflation. 

564-A. INFERTILITY 

A three-day, full-time course given jointly by the 
department of urology and the department of obstet- 
rics and gynecology, December 8 through 10, 1952. 
Problems of steril ity are presented as related to both 
husband and wife. Methods of diagnosis and treat- 
ment are presented by lectures, outpatient demonstra- 
tions, and laboratory techniques. 

Tuition $40.00. 

566-A. CYSTOSCOPY AND ENDOSCOPY 

A part-time course of fifteen sessions, 10 a.m. to 12 
m., Mondays, Wednesdays, and Fridays, September 
15 through October 17, 1952. 

Essentially practical and includes the following sub- 



jects: review of anatomy of the urinary tract, tech- 
nique of cystoscopy and endoscopy, use of water 
dilatation cystoscope, examination of bladder for vari- 
ous pathological conditions, ureteral catheterization 
and passage of bougie, irrigation of renal pelvis, pye- 
lography and intravenous urography, examination 
and treatment of Urethra with both air and water dila- 
tation, fulguration of bladder growths, and indigocar- 
min and phenolsulphonphthalein tests. 

Given under the direction of Dr. Samuel Schmerz- 
ler. Maximum class 6, Tuition $75.00. 

This course is repeated as 566-B, March 23 
through April 24, 1953. 

567-A. GYNECOLOGICAL ENDOCRINOLOGY 

A part-time course of twenty-four sessions, 10 a.m. 
to 12 m., Tuesdays, Thursdays, and Saturdays, Octo- 
ber 7 through December 6, 1952. Consists of the rela- 
tion of the endocrine glands and their hormones to 
physical development, menstrual derangements, ste- 
rility, and menopausal disturbances; the clinical appli- 
cation of organotherapy. An adequate knowledge of 
biological chemistry, histopathology, and the physi- 
ology of the female pelvic organs is required for 
admission to this course because laboratory proce- 
dures are correlated with the daily clinical work. 
Applicants are admitted only after an interview with 
the instructor in charge. This class is invited to attend 
Dr. Mackenzie's lecture on vaginal smears, Tuesdays. 

Given under the direction of Dr. Theodore Neu- 
staedter. Maximum class 4. Tuition $125.00. 

This course is repeated as 567-B, April 14 through 
June 6, 1953. 

568-A. VAGINAL CYTOLOGY (FOR 
SPECIALISTS) 

A part-time course of sixteen sessions, 12 m. to 1 
p.m., Tuesdays, and 9 a.m. to 12 m., Thursdays, 
October 7 through December 4, 1952. Consists of lec- 
tures and laboratory periods dealing with the tech- 
nique of taking, preparing, and examining vaginal 
smears. Subjects of study include the normal vaginal 
cells, changes observed during the menstrual cycle, 
the amenorrheas, pregnancy, the menopause, and 
other physiological and pathological gynecological 
conditions, as well as the diagnosis of malignancy of 
the genital tract. 

Given under the direction of Dr. E. Lawrence 
Hecht. Maximum class 6. Tuition $100.00. 

This course is repeated as 568-B, April 14 through 
June 4, 1953. 



569-A. SURGICAL ANATOMY AS APPLIED 
TO GYNECOLOGY: CAD AVER 

A part-time course of twelve sessions, 11 a.m. to 
12:30 p.m., Tuesdays, Thursdays, and Saturdays, 
October 14 through November 1 1 , 1952, consisting of 
the surgical anatomy of the following Operations con- 
sidered in detail, illustrated by lantern slides and 
blackboard drawings, as well as by dissection: 

1 . Anterior vaginal wall 

a) Relaxed bladder sphincter 

b) Vesicovaginal fistula 

c) Repair of cystocele 

2. Postvaginal wall 

a) Simple perineorrhaphy 

b) Perineorrhaphy with torn anal sphincter 

c) Postcolpotomy 

3. Diagnostic curettage with Insertion of intra- 

uterine pessary 

4. Repair of lacerated cervix 

5. Operations for retro-displaced Uterus (choice 

of technique) 

6. Operations on broad ligaments, tubes, and 

ovaries 

7. Choice of a complete or supracervical hyster- 

ectomy 

8. Operations for gynecological ureteral injuries 

9. Repair of gynecological intestinal injuries 

10. Bladder and sigmoid 

1 1 . Hemorroidectomy 
Restricted to surgeons. 

Given under the direction of Dr. Salvatore di 
Palma. Maximum class 6. Tuition $175.00. 

This course is repeated as 569-B, February 24 
through March 21, 1953. 



734 A. GYNECOLOGY (FOR SPECIALISTS) 

Covers a sixteen-week period, September 2 through 
December 19, 1952. The matriculant's time is fuUy 
occupied from 8:30 a.m. to 12m., Mondays through 
Fridays, and from 1 : 30 to 4 p.m. on Wednesdays. Ses- 
sions are assigned to ward rounds, lectures, and clini- 
cal and laboratory demonstrations. Throughout the 
course, emphasis is directed toward the commonly 
encountered diseases as well as presentation of the 
recent advances in gynecology. 

Among the subjects covered in discussion are the 
diagnosis and treatment of abnormal uterine bleeding, 
gonorrhea, and postabortal infection, radium and 
X-ray in gynecology, newer concepts in the manage- 
ment of Carcinoma of the cervix and fundus of the 
Uterus (including reference to the vaginal smear as a 
method of diagnosis), and sterility in the female. Time 
is devoted to a study of the endopelvic fascia in rela- 
tion to Prolapse and its surgical treatment. The clinical 
management of tumors of the Uterus and ovary are 
reviewed. Finally, there are demonstrations of the 
common procedures in ofifice gynecology. 

Ward rounds emphasize differential diagnosis and 
Problems in the preoperative and postoperative care 
of the patient. A clinical pathological Conference is 
held weekly and includes case teaching, differential 
diagnosis, and pathology in relation to the clinical 
picture. 

The course is given at Beth Israel Hospital under 
the direction of Dr. Henry C. Falk. Maximum class 6. 
Tuition $250.00. 

This course is repeated as 734-B (dates to be 
announced). 



30 



31 



■ I ^ 



OBSTETRICS AND GYNECOLOGY 



scopy, vaginal and endometrial cytology, and gyne- 
cological endocrinology. 

Given under the direction of Professor Emeritus 
Walter T. Dannreuther. Maximum class 6. Tuition 

$150.00. 

This course is repeated as 561-B, April 13 through 

May 9, 1953. 

562-A. GYNECOLOGY: DIAGNOSIS AND OF- 
FICE TREATMENT 

A part-time course of ten sessions, 10 a.m. to 12 
m., Mondays, Wednesdays, and Fridays, October 27 
through November 17, 1952. 

Given under the direction of Dr. Matthew 
Di Giorgi. Maximum class 6. Tuition $50.00. 

This course is repeated as 562-B, February 23 
through March 16, 1953. 

563-A. GYNECOLOGY: DIAGNOSIS AND OF- 
FICE TREATMENT 

A part-time course of fifteen sessions, 2 to 4 p.m., 
Mondays, Wednesdays, and Fridays, September 15 
through October 17, 1952. 

Given under the direction of Dr. Mortimer N. 
Hyams. Maximum class 6. Tuition $75.00. 

This course is repeated as 563-B, March 23 
through April 24, 1953. 

Roth of the above courses are presented by demon- 
strations, lantern slides, and practical application. 
Opportunity is given to examine a large number of 
patients and to develop diagnostic ability. Course 563 
also includes electrotherapy as it applies to gynecol- 
ogy, methods of conization of the uterine cervix, 
uterosalpingography, sterilization by coagulation of 
the uterine cornu, and transuterine insuflflation. 

564-A. INFERTILITY 

A three-day, full-time course given jointly by the 
department of urology and the department of obstet- 
rics and gynecology, December 8 through 10, 1952. 
Problems of sterility are presented as related to both 
husband and wife. Methods of diagnosis and treat- 
ment are presented by lectures, outpatient demonstra- 
tions, and laboratory techniques. 

Tuition $40.00. 

566-A. CYSTOSCOPY AND ENDOSCOPY 

A part-time course of fifteen sessions, 10 a.m. to 12 
m., Mondays, Wednesdays, and Fridays, September 
15 through October 17, 1952. 

Essentially practical and includes the following sub- 



jects: review of anatomy of the urinary tract, tech- 
nique of cystoscopy and endoscopy, use of water 
dilatation cystoscope, examination of bladder for vari- 
ous pathological conditions, ureteral catheterization 
and passage of bougie, Irrigation of renal pelvis, pye- 
lography and intravenous urography, examination 
and treatment of Urethra with both air and water dila- 
tation, fulguration of bladder growths, and indigocar- 
min and phenolsulphonphthalein tests. 

Given under the direction of Dr. Samuel Schmerz- 
ler. Maximum class 6, Tuition $75.00. 

This course is repeated as 566-B, March 23 
through April 24, 1953. 

567-A. GYNECOLOGICAL ENDOCRINOLOGY 

A part-time course of twenty-four sessions, 10 a.m. 
to 12 m., Tuesdays, Thursdays, and Saturdays, Octo- 
ber 7 through December 6, 1952. Consists of the rela- 
tion of the endocrine glands and their hormones to 
physical development, menstrual derangements, ste- 
rility, and menopausal disturbances; the clinical appli- 
cation of organotherapy. An adequate knowledge of 
biological chemistry, histopathology, and the physi- 
ology of the female pelvic organs is required for 
admission to this course because laboratory proce- 
dures are correlated with the daily clinical work. 
Applicants are admitted only after an interview with 
the instructor in charge. This class is invited to attend 
Dr. Mackenzie's lecture on vaginal smears, Tuesdays. 

Given under the direction of Dr. Theodore Neu- 
staedter. Maximum class 4. Tuition $125.00. 

This course is repeated as 567-B, April 14 through 
June 6, 1953. 

568-A. VAGINAL CYTOLOGY (FOR 
SPECIALISTS) 

A part-time course of sixteen sessions, 12 m. to 1 
p.m., Tuesdays, and 9 a.m. to 12 m., Thursdays, 
October 7 through December 4, 1952. Consists of lec- 
tures and laboratory periods dealing with the tech- 
nique of taking, preparing, and examining vaginal 
smears. Subjects of study include the normal vaginal 
cells, changes observed during the menstrual cycle, 
the amenorrheas, pregnancy, the menopause, and 
other physiological and pathological gynecological 
conditions, as well as the diagnosis of malignancy of 
the genital tract. 

Given under the direction of Dr. E. Lawrence 
Hecht. Maximum class 6. Tuition $100.00. 

This course is repeated as 568-B, April 14 through 
June 4, 1953. 



30 



OBSTETRICS AND GYNECOLOGY 



569-A. SURGICAL ANATOMY AS APPLIED 
TO GYNECOLOGY: CADAVER 

A part-time course of twelve sessions, 11 a.m. to 
12:30 p.m., Tuesdays, Thursdays, and Saturdays, 
October 14 through November 11, 1952, consistingof 
the surgical anatomy of the following Operations con- 
sidered in detail, illustrated by lantern slides and 
blackboard drawings, as well as by dissection: 

1. Anterior vaginal wall 

a) Relaxed bladder sphincter 

b) Vesicovaginal fistula 

c) Repair of cystocele 

2. Postvaginal wall 

a) Simple perineorrhaphy 

b) Perineorrhaphy with torn anal sphincter 

c) Postcolpotomy 

3. Diagnostic curettage with Insertion of intra- 

uterine pessary 

4. Repair of lacerated cervix 

5. Operations for retro-displaced Uterus (choice 

of technique) 

6. Operations on broad ligaments, tubes, and 

ovaries 

7. Choice of a complete or supracervical hyster- 

ectomy 

8. Operations for gynecological ureteral injuries 

9. Repair of gynecological intestinal injuries 

10. Bladder and sigmoid 

1 1 . Hemorroidectomy 
Restricted to surgeons. 

Given under the direction of Dr. Salvatore di 
Palma. Maximum class 6. Tuition $175.00. 

This course is repeated as 569-B, February 24 
through March 21, 1953. 



734-A. GYNECOLOGY (FOR SPECIALISTS) 

Covers a sixteen-week period, September 2 through 
December 19, 1952. The matriculant's time is fully 
occupied from 8:30 a.m. to 12 m., Mondays through 
Fridays, and from 1 : 30 to 4 p.m. on Wednesdays. Ses- 
sions are assigned to ward rounds, lectures, and clini- 
cal and laboratory demonstrations. Throughout the 
course, emphasis is directed toward the commonly 
encountered diseases as well as presentation of the 
recent advances in gynecology. 

Among the subjects covered in discussion are the 
diagnosis and treatment of abnormal uterine bleeding, 
gonorrhea, and postabortal infection, radium and 
X-ray in gynecology, newer concepts in the manage- 
ment of Carcinoma of the cervix and fundus of the 
Uterus (including reference to the vaginal smear as a 
method of diagnosis ) , and sterility in the female. Time 
is devoted to a study of the endopelvic fascia in rela- 
tion to Prolapse and its surgical treatment. The clinical 
management of tumors of the Uterus and ovary are 
reviewed. Finally, there are demonstrations of the 
common procedures in office gynecology. 

Ward rounds emphasize differential diagnosis and 
Problems in the preoperative and postoperative care 
of the patient. A clinical pathological Conference is 
held weekly and includes case teaching, differential 
diagnosis, and pathology in relation to the clinical 
picture. 

The course is given at Beth Israel Hospital under 
the direction of Dr. Henry C. Falk. Maximum class 6. 
Tuition $250.00. 

This course is repeated as 734-B (dates to be 
announced). 



31 



■•^ 



OPHTHALMOLOGY 



OPHTHALMOLOGY 



A. Gerard DeVoe, a.b., m.d., med.sc.d., Professor and 

Chairman of the Department 
Rudolf Aebli, a.b., m.d., Professor of Clinical Ophthal- 

mology 
Conrad Berens, m.d., Professor of Clinical Ophthal- 

mology 
George N. Wise, b.s., m.d., med.sc.d., Assistant Professor 
Girolamo Bonaccolto, m.d. [rome], Clinical Professor 
Truman L. Boyes, m.d. [Toronto], Clinical Professor 
Harold W. Brown, b.s., m.d., Clinical Professor 
W. Guernsey Frey, Jr., a.b., m.d., Clinical Professor 
Wendel! L. Hughes, m.d. [western ontario], Clinical 

Professor 
Raymond E. Meek, b.s.(med.), m.d., Clinical Professor 
R. Townley Paton, b.s., m.d., Clinical Professor 
Brittain F. Payne, a.b., m.d., Clinical Professor 
James W. Smith, m.d., Clinical Professor 
Ervin A. Tusak, m.d. [german univ., prague], Clinical 

Professor 
Walter S. Atkinson, m.d.,c.m. [mcgill], Associate Clin- 
ical Professor 
Isadore Givner, b.s.(med.), m.d., Associate Clinical 

Professor 
Alfred Kestenbaum, m.d. [vienna], Associate Clinical 

Professor 
Domenico Cappetta, m.d. [florence], Assistant Clinical 

Professor 
Max Chamlin, a.b., m.d., Assistant Clinical Professor 
Gerald E. Fonda, b.s., m.d., Assistant Clinical Professor 
Sidney A. Fox, a.b., m.d., m.s. (Ophthal.), Assistant 

Clinical Professor 
Bernard Fread, b.s., m.d., Assistant Clinical Professor 
James M. Houlahan, a.b., m.d., Assistant Clinical Pro- 
fessor 

576-A. OPHTHALMOLOGY (GRADUATE 
COURSE) 

A nine months' course, September 29, 1952, 
through June 19, 1953, in the basic sciences as applied 
to ophthalmology, the successful completion of which 
is to be followed by a residency in a hospital approved 
by the school. 

Given under the direction of Professor A. Gerard 
DeVoe. Tuition $700.00. 

571-A. MOTOR ANOMALIES OF THE EYE 
(Part I) (FOR SPECIALISTS) 

A full-time course of six days' duration, March 9 
through 14, 1953. The course is made as practical as 
possible, and the relation of the muscle balance to 
refraction is always considered in the prescribing of 
glasses. Anatomy of the ocular muscles, nerve supply, 
action of individual muscles, anomalies of associated 



Abraham L. Kornzweig, a.b., m.d.. Assistant Clinical 

Professor 
Arthur Linksz, m.d. [kiel], med.sc.d. [pecs], Assistant 

Clinical Professor 
Hunter H. Romaine, m.d., Assistant Clinical Professor 
Anthony A. Scimeca, m.d., Assistant Clinical Professor 
Byron C. Smith, b.s., m.d., Assistant Clinical Professor 
Frederick H. Theodore, a.b., m.d., Assistant Clinical Pro- 
fessor 
Goodwin M. Breinin, B.s., a.m., m.d., Instructor 
J. Gordon Cole, b.s., m.b.. m.d., Instructor 
Frank H. Constantine, a.b., m.d.. Instructor 
William L. Donnelly, m.d., Instructor 
A. Marvin Gillman, a.b.. m.s.(pub.health), m.d.. In- 
structor 
Louis J. Girard, a.b., m.d., Instructor 
Bernard Kronenberg, b.s., m.d. [bern], Instructor 
Joseph H. Krug, a.b., m.d., Instructor 
Walter J. Mäher, m.d., Instructor 
Alfred Weintraub, m.d. [vienna], Instructor 
Leon M. Weiss, b.s., m.d., Instructor 
Joshua Zuckerman, b.s., m.d.,c.m. [mcgill], Instructor 
Irwin J. Cohen, a.b., m.d., Clinical Instructor 
William J. Garvin, Clinical Instructor 
Richard W. Greene, m.d., Clinical Instructor 
Gerald B. Kara, a.b., m.d., Clinical Instructor 
Francis C. Keil, Jr., a.b., m.d.. med.sc.d.. Clinical In- 
structor 
Jesse W. Overton, b.s., m.d., Clinical Instructor 
Bernard A. Roberts, b.s., m.d., Clinical Instructor 
Chih Chiang Teng, m.d. [Shanghai], Clinical Instructor 
Bernard M. Teschner, a.b., m.d., Clinical Instructor 
Howard K. Weisberg, m.d., Clinical Instructor 
Helena Fedukowicz, physician [jekaterinoslaw], 
Fellow 

movements, anomalies of convergence, of divergence, 
and of sursumvergence. Gase demonstrations foUow 
the lectures. 

Given under the direction of Dr. Harold W. Brown. 
Tuition $90.00. 

572-A. MOTOR ANOMALIES OF THE EYE 
(Part H) (FOR SPECIALISTS) 

A full-time course of five days' duration, March 16 
through 20, 1953. A continuation of 571-A, with 
drills in making tests and examination of patients for 
diagnosis. The question of treatment, both operative 
and nonoperative, and the use and limitations of each 
are considered. Open only to those who have taken 
571-A. 

A set or box of prisms is required and must be fur- 
nished by the Student. 

Given under the direction of Dr. Harold W. Brown. 
Tuition $75.00. 



32 



OPHTHALMOLOGY 



573-A. OPHTHALMIC PLASTIC SURGERY 
(FOR SPECIALISTS) 

A part-time course of five days' duration, 2 to 5 
p.m., March 30 through April 3, 1953. This course 
Covers the essentials of Ophthalmie plastic surgery for 
the practicing ophthalmologist. Special emphasis is 
laid on the more common fundamental procedures 
peculiar to lid surgery. These include such minor sur- 
gery as tarsorrhaphy, canthoplasty, excision and 
repair of lid margin lesions as well as the usual classi- 
cal procedures for the correction of ptosis, ectropion, 
entropion, socket lesions, etc. Instruction is by lecture 
and demonstration. The Steps in the various tech- 
niques are systematically outlined and the choice of 
the suitable technique for various clinical conditions 
is considered. 

Given under the direction of Dr. Sydney A. Fox. 
Tuition $75.00. 

574-A. SURGERY OF THE EYE (FOR 
SPECIALISTS) 

A full-time course of six days' duration, October 27 
through November 1, 1952, consisting of lectures on 
cataract surgery, glaucoma surgery, ocular muscle 
surgery, ptosis surgery, surgical treatment of retinal 
detachment, corneal transplantation, and plastic sur- 
gery of the eye. Practical work on technique of eye 
Operations on the cadaver. Operative clinics at the 
University Hospital, Bellevue Hospital, and Lenox 
Hill Hospital. 

Given under the direction of Dr. Rudolf Aebli. 
Maximum class 11. Tuition $100.00. 

This course is repeated as 574-B, March 23 
through 28, 1953. 

575-A. DIFFERENTIAL DIAGNOSIS WITH 
THE SLIT LAMP (FOR SPECIALISTS) 

A part-time course of five days' duration, 9 a.m. to 
1 p.m., November 10 through 14, 1952, consisting of 
differential diagnosis of diseases of the anterior Seg- 
ment of the eyeball and of the different mediums of 
the eye. Includes a thorough demonstration of the 
principles of Illumination by means of the^ slit lamp. 
The important elementary lesions of the conjunctiva, 
Cornea, iris, lens, and vitreous are analyzed and illus- 
trated by means of slides and presentation of cases. 
The diflferential diagnosis of pathological lesions of 
these structures is stressed. 

Given under the direction of Dr. Girolamo Bonac- 
colto. Maximum class 12. Tuition $75.00. 

This course is repeated as 575-B, February 23 
through 27, 1953. 



577-A. EXTERNAL DISEASES OF THE EYE 
(FOR SPECIALISTS) 

A part-time course of five days' duration, 2 to 5 
p.m., November 3 through 7, 1952. Consists of clini- 
cal differential diagnosis of types of Conjunctivitis. 
Office procedures are demonstrated as an aid in differ- 
ential diagnosis. The clinical types of bacterial, virus, 
and allergic inflammations of the outer eye are pre- 
sented with lectures, photographs, and clinical 
demonstrations. 

Given under the direction of Dr. Frederick Theo- 
dore. Tuition $75.00. 

578-A. OCULAR EXPRESSIONS OF SYSTEMIC 
DISEASE 

A part-time course, five days, 2 to 5 p.m., Novem- 
ber 10 through 14, 1952. Covers clinical and 
pathological changes associated with diabetes, hyper- 
tension, nephritis, thyroid dysfunction, blood dyscra- 
sias, and optic-nerve diseases. Some associated eye 
and skin evidences of systemic diseases are discussed. 
These include lupus erythematosus, dermatomyositis, 
sarcoid, brucellosis, and the phakomatoses. 

Given under the direction of Dr. Isadore Givner. 
Tuition $50.00. 

This course is repeated as 578-B, February 23 
through 27, 1953. 

579-A. NEURO-OPHTHALMOLOGY 

A part-time course of five days' duration, 9 a.m. to 
12m., July 14 through 18, 1952. Consists of a review 
of the anatomy of the nerve fibers, instrumental and 
noninstrumental perimetry, Classification and signifi- 
cance of field defects, optic atrophy, chiasmal Syn- 
dromes, and pupillary reactions. Discussion of the 
types of nuclear and peripheral abducenspalsy, 
diverse forms of gaze palsy (supranuclear palsy), 
nystagmus, vertigo, and convergence disturbances. A 
Short review of cerebro-ocular diseases and functional 
disturbances of the eye is given. 

Given under the direction of Dr. Alfred Kesten- 
baum. Tuition $50.00. 

This course is repeated as 579-B, January 19 
through 23, 1953. 

5710-A. PERIMETRY 

A part-time course of five days' duration, 2 to 5 
p.m., July 14 through 18, 1952. An intensive review 
of methods in the practical use of the perimeter and 
tangent screen. Emphasis is laid on the detection of 
minimal defects in the visual fields produced by early 



33 



..■^■.■..a.t^..-^=^-^^^^..*^.«*n.:-»^ 



OPHTHALMOLOGY 



ORTHOPEDIC SURGERY 



lesions, both ocular and intracranial. The differential 
diagnosis of papiiledema, optic neuritis, and various 
congenital and developmental anomalies of the disc 
are considered, making use of the tangent screen. 

Typical field defects produced by classical intra- 
cranial lesions, especially tumors, are demonstrated. 
Their interpretive value in relation to site of lesion, 
localizing or lateralizing value, and other clinical 
interpretations is covered. Methods of recording find- 
ings and transposing them to the chart are reviewed. 
Further attention is paid to the quality of defective 
fields and methods of recording such qualities. Em- 
phasis is placed on the follow-up of visual fields in 
brain tumor cases being treated with radiotherapy. 

Given under the direction of Dr. Max Chamlin. 
Tuition $50.00. 

This course is repeated as 5710-B, January 19 
through23, 1953. 

571 1-A. OPHTHALMOSCOPY 

A part-time course of five days' duration, 9 a.m. to 
12 m., July 21 through 25, 1952. A study of ophthal- 
moscopic diseases of the vitreous, retina, choroid, and 
optic nerve. Congenital anomalies and traumatic fun- 
dus changes. Manifestations of general diseases in the 
eye grounds. Ophthalmoscopic case presentations. 
Students are required to bring their own ophthalmo- 
scopes. 

Given under the direction of Dr. George N. Wise. 
Tuition $50.00. 

Practical Instruction in Ophthalmology 



This course is repeated as 571 1-B, January 26 
through 30, 1953. 

5713-A. OCULAR THERAPEUTICS 

A part-time course of five days' duration, 1 to 4 
p.m., July 21 through 25, 1952, which reviews current 
methods of therapy in ocular diseases. Although 
emphasis is placed on medical treatment, indication 
for surgical Intervention is also discussed. Particular 
attention is directed to the antibiotics, adrenocortico- 
tropic hormones, and the newer antiglaucomatous 
drugs. 

Given under the direction of Dr. A. Gerard DeVoe. 
Tuition $50.00. 

This course is repeated as 5713-B, January 26 
through 30, 1953. 

5714-A. HISTOPATHOLOGY 

A part-time course of six days' duration, 1 to 4 
p.m., September 22 through 27, 1952. Consists of lec- 
tures, demonstrations, and microscopic study of intra- 
ocular inflammations, pyogenic, nonspecific, specific 
granulomas, tumors of the eye and adnexae, path- 
ology of glaucoma, pathology of trauma and compli- 
cations following intraocular surgery, pathology of the 
eye in systemic disease states. All this to be introduced 
with a lecture on general principles of Ophthalmie 
pathology and a System for reading Ophthalmie 
pathology slides. 

Given under the direction of Dr. A. Marvin Gill- 
man. Tuition $100.00. 



ORTHOPEDIC SURGERY 



^i 



\ 

l 

I 
V 



S^ 



LV ^^ 






Walter A. L. Thompson, m.d., Professor and Chairman 

of the Department 
George Anapol, m.d., Professor of Clinical Orthopedic 

Surgery 
John C. McCauley, Jr., b.s., m.d., Associate Professor 
M. Beckett Howorth, b.s., m.d., med.sc.d., Clinical Pro- 
fessor 
William H. Irish, m.d., Clinical Professor 
Ernst W. Bergmann, m.d. [erlangen], Associate Clinical 

Professor 
William A. Walker, a.b., m.d., Associate Clinical Pro- 
fessor 
Joseph Buchman, b.s., m.d., Assistant Clinical Professor 
Alvin Hulnick, a.b., m.d., Assistant Clinical Professor 
Samuel H. Nickerson, b.s., m.d., cm. [mcgill], Assistant 

Clinical Professor 
Antonio J. Pisani, B.s., m.d., Assistant Clinical Professor 
Robert L. Preston, B.s., m.d., Assistant Clinical Professor 
Mario E. Stella, B.s., m.d., Assistant Clinical Professor 

Postgraduate courses of varying duration may be 
undertaken by special arrangement on a prorata basis 
of $100.00 per month, füll time. 

58 1-A. BASIC SCIENCES AS RELATED TO 
ORTHOPEDIC SURGERY (GRADUATE 
COURSE) 

A full-time course of six months' duration, January 
5 through June 19, 1953, for orthopedic surgeons who 
intend to achieve American Board certification. The 
course includes anatomical dissection, pathology, 
physiology, biochemistry, microbiology, and pharma- 
cology. The study of bone tumors is under the direc- 
tion of Dr. Bradley L. Coley. Conferences correlating 
the basic sciences with clinical orthopedics are held 
under the direction of Dr. M. Beckett Howorth. 

Given under the direction of Professor Walter A. L. 
Thompson. Maximum class 20. Tuition $450.00. 

582-A. ORTHOPEDICS IN GENERAL 
PRACTICE 

A full-time course of five days' duration, October 
13 through 17, 1952. A review of orthopedic condi- 
tions encountered in general practice. Common errors 
made in the treatment of fractures is included. Instruc- 
tion is given in Bellevue and University Hospitals by 
means of ward rounds and Conferences and clinics. 
Extensive clinical material makes possible the presen- 
tation of the course by practical demonstrations. 

Given under the direction of Professor Walter A. L. 
Thompson. Maximum class 20. Tuition $75.00. 

This course is repeated as 582-B, June 15 through 
19, 1953. 



David M. Bosworth, a.b., m.d., Lecturer 

George D. Appold, B.s., m.d., Instructor 

Alvin M. Arkin, b.s., m.d., m.s., Instructor 

Arthur I. Blieden, b.s., m.b., m.d., Instructor 

Irving V. Glick, a.b., m.d., Instructor 

Constantine L. Jeannopoulos, a.b., m.d. [rome], In- 
structor 

Albert J. Schein, b.s., m.d., Instructor 

John P. Stump, a.b., m.d., Instructor 

Harry Weiner, m.d., Instructor 

H. Leslie Wenger, d.s. (med.), m.d., Instructor 

Edward J. Haboush, b.s. (med.), m.d., Instructor in Clini- 
cal Orthopedic Surgery 

Albert B. Accettola, b.s., m.d., Assistant 

Emanuel Blumenfeld, b.s., m.d., Assistant 

Maccabae Boorstein, b.s., m.d., Assistant 

Robert M. Richman, a.b., m.d., Assistant 

John T. Croft, m.d., Assistant in Clinical Orthopedic 
Surgery 

583-A. ANATOMY FOR ORTHOPEDIC 
SURGEONS 

A full-time course of five days' duration, January 5 
through 9, 1953, providing the students with the 
opportunity to personally dissect the extremities and 
the spine. The instruction is given by qualified ortho- 
pedic surgeons actively engaged in clinical work and 
particularly experienced in anatomy. 

Given under the direction of Dr. Alvin Hulnick. 
Maximum class 20. Tuition $90.00. 

Correlation of Diagnostic ond Therapeutic Procedures 

in Children's Orthopedics 








. J\ 




-Si 



: y^ 



'/ 



OTORHINOLARYNGOLOGY 



OTORHINOLARYNGOLOGY 



OTORHINOLARYNGOLOGY 



John F. Daly, a.b., m.d., Professor and Chairman of the 

Department 
James B. Shannon, m.d., Professor of Clinical Otorhino- 

laryngology 
Joseph L. Goldman, a.b., m.d., Associate Professor of 

Clinical Otorhinolaryngology 
William Wallace Morrison, m.d. [western ontario], 

Associate Professor of Clinical Otorhinolaryngology 
Paul S. Seager, a.b., m.d., Associate Professor of Clinical 

Otorhinolaryngology 
John C. Cardona, a.b., m.d., Assistant Professor of Clin- 
ical Otorhinolaryngology 
Daniel S. Cunning, m.d., Clinical Professor 
Andrew A. Eggston, b.s., m.d., Clinical Prof essor of Path- 

ology (Otorhinolaryngology) 
J. Swift Hanley, a.b., m.d.,c.m. [queen's univ., Kings- 
ton], Clinical Professor 
Girard F. Oberrender, b.s., m.d., Clinical Professor 
Greydon G. Boyd, a.b., b.s., m.d., Associate Clinical Pro- 
fessor 
Virginius B. Hirst, b.s., m.d., Associate Clinical Professor 
Earl F. Limbach, a.b., m.d., Associate Clinical Professor 
William B. Allan, b.s., m.d., Assistant Clinical Professor 
Miles Atkinson, m.b.,b.s. [London], Assistant Clinical 

Professor 
Richard J. Bellucci, b.s., m.s., m.d., Assistant Clinical 

Professor 
David Bernstein, b.s., m.d., Assistant Clinical Professor 
John A. Cinelli, a.b., m.d. [rome], Assistant Clinical Pro- 
fessor 
Ward C. Denison, m.d., Assistant Cliniral Professor 
Charles W. Depping, m.d., Assistant Clinical Professor 
David \. Frank, m.d., Assistant Clinical Professor 
Leopold L Glushak, m.b.,ch.b. [Glasgow], Assistant 

Clinical Professor 
Joseph H. Hersh, b.s., m.d., Assistant Clinical Professor 

593-A. BASIC SCIENCES OF OTORHINO- 
LARYNGOLOGY (GRADUATE COURSE) 

A full-time course of nine months' duration, Sep- 
tember 29, 1952, through June 19, 1953, designed 
particularly for those who intend to specialize in 
otorhinolaryngology and who will complete their 
training with a residency. Emphasis is placed on the 
basic sciences and the allied clinical subjects of 
otorhinolaryngology, such as allergy, neurology, dis- 
eases of the ehest, bronchoscopy, and head and neck 
surgery. These are covered in detail in their relation- 
ship to Problems of otorhinolaryngology. The course 
is planned to give the Student a firm foundation in the 
basic sciences, the fundamentals of diagnosis, and a 
broad outlook on ear, nose, and throat problems that 
arise in other clinical fields. 

Given under the direction of Professor John F. 
Daly. Tuition $700.00. 



36 



William J. Hochbaum, a.b., m.d., Assistant Clinical Pro- 
fessor 
Alexander F. Laszlo, m.d. [Budapest], Assistant Clinical 

Professor 
Anthony Nigro, m.d., Assistant Clinical Professor 
Max Rabbiner, b.s.(med.), m.d., Assistant Clinical Pro- 
fessor 
Max L. Som, b.s., m.d., Assistant Clinical Professor 
Darrell G. Voorhees, b.s., m.d., Assistant Clinical Pro- 
fessor 
Ernest A. WeymuUer, b.s., m.d., Assistant Clinical Pro- 
fessor 
Joseph E. Zbar, a.b., m.d.,c.m. [queen's univ., Kings- 
ton], Assistant Clinical Professor 
Walter A. Petryshyn, a.b., m.d., Instructor in Clinical 

Otolaryngology 
Murray Abrams, b.s., m.d., Clinical Instructor 
Godfrey E. Arnold, m.d. [vienna], Clinical Instructor 
Mark H. Barnes, a.b., m.d., Clinical Instructor 
Louis F. Castaldo, b.s., m.d., Clinical Instructor 
James V. Conway, a.b., m.d., Clinical Instructor 
Rector T. Davol, a.b., m.d., Clinical Instructor 
Louise Fischer, b.s., m.d., Clinical Instructor 
Joseph Freeman, a.b., m.d., Clinical Instructor 
Otto Gambacorta, a.b., m.d., Clinical Instructor 
Edward S. Orzac, m.d., Clinical Instructor 
Ralph Peimer, a.b., m.d., Clinical Instructor 
Alan A. Scheer, m.d., Clinical Instructor 
Francis S. Weinstein, b.s., m.d., Clinical Instructor 
Joseph P. Connolly, b.s., m.d., Clinical Assistant 
Samuel Eisenberg, b.s., m.d. [vienna], Clinical Assistant 
Seymour Jacobson, a.b., m.d., Clinical Assistant 
Saul C. Newman, b.s., m.d., Clinical Assistant 
Frank J. Riccio, b.s., m.d. [rome], Clinical Assistant 
Morris M. Rossman, a.b., m.d. [rome], Clinical Assistant 
Francis Kwok, m.d. [st. john's univ., Shanghai], 
Fellow 

591-A. INTENSIVE COURSE IN BASIC 
SCIENCES 

An intensive ten-day course in basic sciences— 
including embryology, anatomy, physiology, bacteri- 
ology, principles of operative surgery, and audiology— 
9 a.m. to 1 p.m., September 15 through 26, 1952. 

Given under the direction of Professor John F. 
Daly. Maximum class 12. Tuition $100.00. 

This course will be repeated in the spring of 1953. 

592-A. HISTOPATHOLOGY OF THE EAR, 
NOSE, AND THROAT 

An intensive review of histology and the general 
and special pathology of the ear, nose, throat, and 
head and neck. Material is covered using microscopic 
slides, demonstrations, lectures, and specimens. The 
clinical course of the common pathological processes 
is discussed. Given for a ten-day period, 2 to 5 p.m., 




Practkol Instruction in the Ute of the Bronchoscop« 



OTORHINOLARYNGOLOGY 



PATHOLOGY 



September 15 through 26, 1952. 

Given under the direction of Dr. Andrew A. Egg- 
ston and staflf. Maximum class 12. Tuition $100.00. 

This course will be repeated in the spring of 1953. 

594-A. ENDAURAL SURGERY 

A full-time course of ten days' duration, November 
10 through 21, 1952. The anatomy of the temporal 
bone is presented and the technique of endaural sur- 
gery is taught using cadaver material. The indications 
for temporal bone surgery are discussed in lectures 
and Seminars. 

Given under the direction of Professor John F. 
Daly. Maximum class 7. Tuition $150.00. 

This course will be repeated as 594-B, February 9 
through 20, 1953. 

595-A. ADVANCED BRONCHOESOPHA- 
GOLOGY AND LARYNGOLOGY 

The presentation of recent advances in the manage- 
ment of diseases of the larynx, esophagus, and 
tracheobronchial tree. Current trends and new tech- 
niques are presented in seminars and demonstrations. 
Subjccts covered include: Suspension laryngoscopy, 
pediatric bronchoscopy, and voice and Speech prob- 
lems, as well as an intensive review of the diseases 
commonly seen by the endoscopist. A full-time course 
of five days' duration, January 19 through 23, 1953. 

Given under the direction of Professor John F. 
Daly. Maximum class 12. Tuition $100.00. 

596-A. ANATOMY OF THE HEAD, NECK, AND 
THORAX FOR OTOLARYNGOLOGISTS 

A part-time six weeks' course giving complete ana- 
tomical dissection of the head and neck and thorax, 
supplemented with lectures, demonstrations, and dis- 
cussion groups. Given 9 a.m. to 12 m., Mondays 
through Fridays, September 29 through November 7, 
1952. 

Given under the direction of Professor John F. 
Daly. Tuition $125.00. 

597-A. NEUROANATOMY, NEUROPHYSI- 
OLOGY, AND NEURO-OTOLOGY 

A five-day course, full-time, November 3 through 
7, 1952. The neuroanatomy of the cranial nerves and 
their principle pathways is presented. Physiology of 
vestibulär apparatus-hearing, voice, and speech, plus 
their clinical application— is covered. 



38 



Given under the direction of Professor John F. 
Daly. Tuition $75.00. 

598-A. PATHOLOGY OF THE HEAD AND 
NECK 

This course of four weeks' duration is given 9 a.m. 
to 12 m., November 24 through December 19, 1952. 
It Covers a complete review of general pathology and 
its application to ear, nose, and throat problems. Par- 
ticular attention is given to normal histology of the 
nose, sinuses, Upper digestive and respiratory tracts, 
and histopathology of the temporal bone. Consider- 
able time is spent on pathology of tumors of the head 
and neck that fall within the realm of the specialty of 
otolaryngology. The students are given training in 
slide diagnosis with unknown material. 

Given under the direction of Professor John F. 
Daly. Tuition $125.00. 

599-A. ALLERGY FOR OTOLARYNGOLO- 
GISTS 

Principles and practical methods of treatment for 
allergic diseases of the Upper respiratory tract are pre- 
sented in lectures and clinical demonstrations. A five- 
day, full-time course, December 8 through 12, 1952. 

Given under the direction of Professor John F. 
Daly and Dr. Will Cook Spain. Tuition $75.00. 

5910-A. SURGERY OF THE HEAD AND NECK 

The modern surgical procedures in the head and 
neck region covered in lectures and on the cadaver. 
Surgery of the nose, paranasal sinuses, oral cavity, and 
salivary glands. Basic procedures in neck surgery cov- 
ering laryngectomy, laryngofissure, cysts of neck, 
arytenoidectomy, diverticulum, and neck dissection 
are included. A ten-day, full-time course, January 5 
through 16, 1953. 

Given under the direction of Professor John F. 
Daly. Maximum class 8. Tuition $200.00. 

591 1-A. ADVANCED SURGERY OF THE NECK 

Principles of block dissections of the neck and its 
variations for the qualified laryngeal surgeon. Supra- 
omohyoid, complete radical neck, bilateral and uni- 
lateral radical neck dissection in continuity with 
laryngectomy and pharyngectomy. A ten-day, full- 
time course, September 29 through October 10, 1952. 

Given under the direction of Professor John F. 
Daly. Maximum class 4. Tuition $250.00. 



PATHOLOGY 

College of Medicine 



« 



f 



William C. Von Glahn, b.s., m.d., Professor and Chair- 

man of the Department 
Maurice N. Richter, b.s., m.d., Professor 
Sigmund L. Wilens, s.S., m.d., Professor 
John W. Hall, e.s., m.d., Associate Professor 
Lewis D. Stevenson, a.b., m.d., cm. [queen's univ., 

KINGSTON], Associate Professor of Neuro pathology 
Stanley Gross, B.s., m.d., Assistant Professor 
Adolf Hochwald, m.d. [masaryk univ.], Assistant Pro- 
fessor 
Leon Sokoloflf, a.b., m.d., Assistant Professor 
William Antopol, b.s., m.d., Clinical Prof essor 
Andrew A. Eggston, b.s., m.d., Clinical Professor (Oto- 
rhinolaryngology) 

441-A. GYNECOLOGICAL PATHOLOGY 
(FOR SPECIALISTS) 

A part-time course of sixteen sessions, 1 1 a.m. to 1 
p.m., Wednesdays, September 17 through December 
31, 1952. Consists of a systematic review of the 
pathology of the more common gynecological condi- 
tions, presented by lectures, demonstrations, and 
microscopic study. The correlation of clinical and 
pathological features is emphasized. (442-A is a pre- 
requisite for this course.) 

Given under the direction of Dr. Maxwell J. Fein. 
Maximum class 16. Tuition $100.00. 

This course is repeated as 44 1 -B, 2 : 30 to 4 : 30 p.m., 
Tuesdays and Thursdays, January 20 through March 
17, 1953. 

442-A. SURGICAL PATHOLOGY 
(FOR SPECIALISTS) 

A part-time course of thirty sessions, 2:30 to 4:30 
p.m., Tuesdays and Thursdays, September 16 through 
January 13, 1953. Designed for surgeons and patholo- 
gists. Consists of the study of important pathological 
conditions with particular reference to those of inter- 
est in general surgery. Instruction is by lectures, dem- 
onstrations, and the study of gross and microscopic 
preparations. Material from the operating rooms of 
the University Hospital is available for demonstra- 
tions of gross specimens, and prepared slides illustrate 
microscopic changes. The pathological changes are 
correlated with clinical findings whenever possible. 

Given under the direction of Dr. Maxwell J. Fein. 
Maximum class 16. Tuition $200.00. 

This course is repeated as 442-B, March 17 through 
June 25, 1953. 



Maxwell J. Fein, m.d., Clinical Professor 

Norman S. Cooper, a.b., m.d., Instructor; Dean W. 

Horace Hoskins Fellow in Comparative Pathology 
Antonio Rottino, b.s., m.d., Instructor 
Harry D. Bucalo, Jr., m.d., Assistant 
Barbara S. Ferguson, a.b., m.d., Assistant 
*Sidney Z. Gellman, m.d., Assistant 
Ruth Güssen, a.b., m.d., Assistant 
William J. Hutchins, B.s., m.s., m.d., Assistant 
Robert T. McCIuskey, a.b., m.d., Assistant 
Gloria A. Rudisch, Assistant 
Harry H. Stumpf, a.b., m.d., Assistant 

*Leave of absence, military service. 

443-A. PRINCIPLES OF PATHOLOGY 

Review of principles of general pathology with 
study of the characteristic lesions found in various dis- 
eases. Conducted with lectures and demonstrations of 
gross material and histologic preparations. Especial 
emphasis on correlation of clinical and pathologic fea- 
tures. Twenty-four sessions, 1 to 4 p.m., Mondays and 
Wednesdays, September 29 through December 17, 
1952. Given for students in the graduate courses, but 
open to others providing Space permits. 

Given under the direction of Professor William C. 
Von Glahn. Tuition $100.00. 

444-A. SPECIAL PATHOLOGY FOR 
SURGEONS 

Prerequisite: Course no. 443-A, Principles of 
Pathology. Presentation of material that is of interest 
to the general surgeon, consisting of gross specimens 
and histologic preparations with correlation of clinical 
and pathologic aspects. Twenty-four sessions, Thurs- 
days, 1 to 4 p.m., January 8 through June 18, 1953. 

Given under the direction of Professor William C. 
Von Glahn. Tuition $125.00. 



Surgical Pathology Taught by Class Demonstration 

and Individual Observation 



- I 



PEDIATRICS 



PEDIATRICS 



Adolph G. DeSanctis, m.d., Professor and Chairman 

of the Department 
Leslie O. Ashton, b.s., m.d., Professor of CUnical Pedi- 

atrics 
Rosa Lee Nemir, a.b., m.d., Associate Professor 
John Dorsey Craig, d.s., m.d., Associate Professor of 

CUnical Pediatrics 
D. William Scotti, m.d., Associate Professor of CUnical 

Pediatrics 
Beatrice Bergman, m.d., Assistant Professor of CUnical 

Pediatrics 
Oliver L. Stringfield, s.S., m.d., Assistant Professor of 

CUnical Pediatrics 
Julian Rogatz, m.d., Associate CUnical Professor 
Frederick Castrovinci, a.b., a.m., m.d., Assistant CUn- 
ical Professor 
Robert Chobot, a.b., m.d., Assistant CUnical Professor 
Edward M. DiTolla, m.d., Assistant CUnical Professor 
Daniel J. Dolan, a.b., m.d., Assistant CUnical Professor 
Louis Hodes, b.s., m.d., a.m., Assistant CUnical Pro- 
fessor 
Vincent de Paul Larkin, a.b., m.d., Assistant CUnical 

Professor 
Martin M. Maliner, m.d., Assistant CUnical Professor 
Benjamin Silberg, m.d., Assistant CUnical Professor 
Irwin F. Sobel, a.b., m.d., Assistant CUnical Professor 
Edward T. Wilkes, b.s., m.d., Assistant CUnical Pro- 
fessor 
Oscar Bodansky, a.b., a.m., ph.d., m.d., Lecturer 
* Robert J. Waldron, a.b., m.d., Instructor 
Philip S. Chasin, b.s.; m.d. [Düsseldorf], Instructor in 

CUnical Pediatrics 
Francis C. DeLorenzo, b.s., m.d., Instructor in CUnical 

Pediatrics 
Joseph Di Leo, m.d. [Bologna], Instructor in CUnical 

Pediatrics 
Peter A. Perillo, a.b., m.d., Instructor in CUnical Pedia- 
trics 

6110-A. PEDIATRICS (GRADUATE COURSE) 

A full-time course of nine or twelve months' dura- 
tion, beginning September 22, 1 952, covering not only 
experience in the care of infants and children but also 
lectures in the basic sciences, microbiology, chemistry, 
and physiology. Pediatric experience is obtained on 
the wards of the University Hospital as well as in Chil- 
dren's Medical Service, Bellevue, St. Vincent's, and 
Memorial Hospitals, and Irvington House for Cardiac 
Children, where, in addition to the usual pediatric 
Problems, specialties such as tuberculosis, cardiology, 
allergy, tumors, care of the newborn, etc., may be 
studied. The well-baby clinic furnishes experience 
with the Problems of infant feeding and immunization, 
and experience in the appraisal of growth and devel- 



George E. Pittinos, a.b., m.d., Instructor in CUnical 

Pediatrics 
Joseph F. Raflfetto, a.b., m.d., Instructor in CUnical 

Pediatrics 
Alfred B. Amier, m.d. [Lausanne], CUnical Instructor 
Sol D. Amsterdam, b.s., a.m., m.d. [Lausanne], CUnical 

Instructor 
*Noah Barysh, b.s., m.d., CUnical Instructor 
Nathan Cabot, s.S., m.d., CUnical Instructor 
Marie L. Cote, a.b., m.d., CUnical Instructor 
James Dick, a.b., m.d., CUnical Instructor 
Harold S. Douglas, m.d., CUnical Instructor 
Sol N. Keen, b.s., m.d., CUnical Instructor 
Thomas F. X. Lenihan, a.b., m.d., CUnical Instructor 
Harold R. Mancusi-Ungaro, a.b., m.d., CUnical In- 
structor 
William P. Riley, b.s., m.d., CUnical Instructor 
Flora F. Silberbush, m.d. [basel], CUnical Instructor 
Pasquale A. Statile, b.s., m.d., CUnical Instructor 
Harold D. Dundy, b.s., m.d., Assistant 
James J. Farley, m.d., Assistant 
Vincent J. Felitti, a.b. (med.), m.d., Assistant 
B. Winston Jarvis, b.s., m.d., Assistant 
ehester H. Myron, a.b., m.d., Assistant 
Italo Palmieri, m.d., Assistant 
Frank A. Delaney, ph.b., a.m., CUnical Assistant 

(Speech) 
Vincent J. Fiocco, b.s., m.d., CUnical Assistant 
Bernard Greenberg, b.s., m.d., CUnical Assistant 
Rafael R. Muniz, b.s., m.d., CUnical Assistant 
A. Downey Osborn, b.s.; m.b.,ch.b. [Edinburgh], CUni- 
cal Assistant 
Lewis J. Schloss, a.b., m.d., CUnical Assistant 
Lawrence M. Shapiro, a.b., m.d., CUnical Assistant 
Brona Szuldberg, m.d. [warsaw], CUnical Assistant 
Martin Turkish, b.s., m.d., CUnical Assistant 
Irving H. Uvitsky, m.d., CUnical Assistant 
*Leave of absence. 

opment is obtained in a developmental clinic. Oppor- 
tunities are given to attend seminars, Conferences, and 
lectures in the department, including those on child 
psychiatry. Extensive experience in the reading of 
X-rays in children is furnished and supervised by both 
clinicians and radiologists. 

Given under the direction of Dr. Rosa Lee Nemir. 
Maximum class 12. Tuition $700.00. 

611-A. CLINICAL PEDIATRICS 

A ten-week, part-time course of thirty sessions, 9 
a.m. to 1 p.m., Mondays, Wednesdays, and Fridays, 
November 3, 1952, through January 16, 1953, 
designed for the general practitioner or pediatrician 
who can devote only part of his time each week to 
refresher studies. Consists of didactic lectures, bedside 



40 



.>ter 



PEDIATRICS 



rounds, clinical Conferences, case demonstrations, and 
active participation in the various specialty clinics. All 
basic pediatric problems are reviewed. Special empha- 
sis is placed on normal development in infancy and 
childhood, infant care and feeding (including the pre- 
mature), chemo- and antibiotic therapy, pediatric 
endocrinology, preventive pediatrics, pediatric X-ray 
diagnosis, and the management of acute and chronic 
illnesses. 

Given under the direction of Professor Adolph G. 
DeSanctis. Tuition $125.00. 

612-A. CLINICAL PEDIATRICS 

A full-time course of four weeks' duration, October 
6 through 31, 1952. A review of clinical pediatrics 
including ward rounds, clinical Conferences, and case 
demonstrations in special clinics dealing with cardi- 
ology, allergy, endocrinology, ehest diseases, and 
Speech defects. Clinical lectures on neurological, 
orthopedic, urological, surgical, and otolaryngological 
conditions are given by specialists in these fields. 
Recent developments in antibiotic therapy, infant 
nutrition, and infectious and metabolic diseases are 
discussed. The practical application of these develop- 
ments is stressed from the viewpoint of the general 
practitioner as well as the pediatrician. Active partici- 
pation on the wards and in the clinics of the University 
Hospital is included in the program for each physician 
enrolled in this course. Each participating physician is 
assigned to examine patients on admission to the hos- 
pital, to perform diagnostic and therapeutic proce- 
dures as indicated, and to follow the progress of 
individual patients. 

Given under the direction of Professor Adolph G. 
DeSanctis. Maximum class 16. Tuition $150.00. 

613-A. PEDIATRIC REFRESHER COURSE 

A full-time course of two weeks' duration, January 
19 through 31, 1953. A variety of common pediatric 
Problems are presented in clinical lectures and Confer- 
ences. Specialists in the various phases of pediatrics 
conduct ward rounds and present interesting cases. 
Recent developments are presented along with basic 
considerations. 

Given under the direction of Professor Adolph G. 
DeSanctis. Tuition $100.00. 

614-A. REVIEW OF CLINICAL PEDIATRICS 

A full-time course of six days' duration, September 
8 through 13,1 952, consisting of a review of the prac- 
tical Problems encountered in pediatric practice. 
Clinical lectures, Conferences, ward rounds, and case 
demonstrations are given by specialists in the various 



phases of pediatrics. Special emphasis is placed on 
infant feeding, preventive pediatrics, chemotherapy, 
cardiology, and care of the premature infant. 

Given under the direction of Professor Adolph G. 
DeSanctis. Maximum class 40. Tuition $50.00. 

This course is repeated as 614-B, March 9 through 
14, 1953. 

615-A. PRACTICAL PEDIATRIC 
ENDOCRINOLOGY 

A part-time course of ten sessions, 1 a.m. to 12m., 
Thursdays, April 2 through June 4, 1953, in the basic 
principles and clinical applications of the most recent 
advances in pediatric endocrinology. Consists of 
didactic lectures, case demonstrations, and Confer- 
ences. Patients are presented and, whenever neces- 
sary, additional material is presented in detail with the 
use of lantern slides and photographs. In each instance 
the practical aspects of pediatric endocrinology are 
stressed. An organized system of diagnosis and man- 
agement is offered. Designed for pediatricians but, 
enrollment permitting, is available to general 
practitioners. 

Given under the direction of Dr. Beatrice Bergman. 
Tuition $50.00. 

616-A. PEDIATRIC ALLERGY 

A part-time course of ten sess"ons, 9:30 a.m. to 
12:30 p.m., Tuesdays, April 7 through June 9, 1953. 
Consists of didactic lectures, ca.«? dernonstrations, 
clinical Conferences, and active participation in the 
Pediatric Allergy Clinic of the University Hospital. All 
Problems commonly encountered in allergic children 
are discussed in detail. Special emphasis is placed on 
the management of hay fever, eczema, asthma, gas- 
trointestinal allergies, practical experience with skin 
testing and other diagnostic techniques, drug allergies, 
and the use of the new antihistaminic preparations. 
Designed for pediatricians but, enrollment permitting, 
is available to general practitioners. 

Given under the direction of Dr. Robert Chobot. 
Tuition $60.00. 

617-A. COMMUNICABLE DISEASES 

An intensive full-time course of five days' duration, 
January 12 through 16, 1953, in the basic and practi- 
cal aspects of the common communicable diseases. 
The Problems encountered are discussed by outstand- 
ing authorities in lectures, and the participating physi- 
cian actively engages in the examination of patients at 
the Willard Parker Hospital for Contagious Diseases. 
Basic diagnostic and therapeutic principles are em- 



41 



^11 »»■III I )ll~ 



PEDIATRICS 



PHARMACOLOGY 



phasized. A summary of present aspects of tubercu- 
losis as it is encountered in children is also included. 
Given under the direction of Dr. John Dorsey 
Craig. Tuition $50.00. 

618-A. PEDIATRIC CARDIOLOGY 

A full-time course of five days' duration, September 
15 through 19, 1952. Offers an intensive review of the 
most recent advances in pediatric cardiology including 
rheumatic fever, rheumatic heart disease, and con- 
genital heart disease. The various diagnostic proce- 
dures are included, such as electrocardiography, 
fluoroscopy, cardiac visualization, and venous cathe- 
terization. An attempt is made to present the most 
practical and most modern means of treating the vari- 
ous cardiac problems as they arise. 

Given under the direction of Dr. Martin M. 
Maliner. Maximum class 30. Tuition $50.00. 

619-A. PEDIATRIC CARDIOLOGY 

A part-time course of ten sessions, Wednesdays, 9 
a.m. to 12 m., April 1 through June 3, 1953. Consists 



of didactic lectures, case demonstrations and Confer- 
ences, and active participation in the Pediatric 
Cardiac Clinic of the University Hospital. Special 
emphasis is placed on the basic considerations of 
pediatric cardiology. Among the numerous topics 
considered are rheumatic fever, congenital heart dis- 
orders, fluoroscopic and X-ray examination of the 
normal and pathological heart (including cardiac 
visualization with contrast mediums and venous 
catheterization ) , normal and abnormal electrocardio- 
grams, acute infections as related to pediatric cardi- 
ology, surgical correction of congenital anomalies, 
anesthesia in cardiac children, and the newer drugs 
used in the therapy of cardiac disorders. Ample 
opportunity is offered to study actual cases in the 
Pediatric Cardiac Clinic. Diagnosis and surgical treat- 
ment of congenital cardiac disease is included. De- 
signed for pediatricians but, enroUment permitting, is 
available to general practitioners. 

Given under the direction of Dr. Martin M. 
Maliner. Tuition $60.00. 



PHARMACOLOGY 



College of Me die ine 



X*- 



Severe Ochoa, m.d. [madrid], Professor and Chairman 

of the Department 
Otto Loewi, M.D. [STRASBOURG], sc.d.(hon.), Research 

Professor 
Richard C. de Bodo, m.d. [Budapest], Associate Pro- 
fessor 
Seymour Korkes, m.d., Assistant Professor 
Sarah Ratner, a.b., a.m., ph.d., Assistant Professor 
Seymour Kaufman, b.s., m.s., ph.d., Instructor 
Joseph R. Stern, a.b., a.m., m.d. [Toronto], Instructor 
Minor J. Coon, a.b., ph.d., Fellow 
Osvaldo Cori, med. cir. [chile], Fellow 



Issac Harary, a.b. [western ontario], Fellow 
Saul R. Korey, m.d., Fellow 
Nathan Lane, a.b., m.d., Fellow 
Dorothy Newmeyer, b.s., m.s., ph.d., Fellow 
Marvin W. Sinkoff, a.b., m.d., Fellow 
Harold J. Strecker, b.s., ph.d.. Fellow 
Wolf Vishniac, a.b., m.s., ph.d., Fellow 
Israel Zelitch, b.s., m.s., ph.d., Fellow 

The members of the department take part in the basic 
science instruction in the courses oflfered by the clinical 
departments. 

Modern Clinical Investigation 



W 



Care of the Premoture Infant 




""-^ 








I 
•■ I 



i 




V 



PHYSICAL MEDICINE AND REHABILITATION 



I 



PHYSICAL MEDICINE AND REHABILITATION 



PHYSICAL MEDICINE AND REHABILITATION 

College of Medicine 



Howard A. Rusk, a.b., m.d., sc.d.(hon.), ll.d., Pro- 
fessor and Chairman of the Department 

George G. Deaver, b.p.e., m.d., Professor of Clinical 
Rehabilitation 

Donald A. Covalt, b.s., m.d., Associate Professor of 
Rehabilitation 

Hans Kraus, m.d. [vienna], Associate Professor of Clin- 
ical Physical Medicine and Rehabilitation 

Joseph Moldaver, m.d., Associate Professor of Clinical 
Physical Medicine and Rehabilitation 

Edward W. Lowman, b.s., m.d., m.s.(med.), Assistant 
Professor 

Allen S. Russek, a.b., l.r.c.p.s. [Edinburgh, Glasgow], 
Assistant Professor 

Joseph G. Benton, a.b., m.s., ph.d., m.d., Adjunct Assist- 
ant Professor 

Michael M. Dacso, m.d. [Budapest], Assistant Professor 
of Clinical Physical Medicine and Rehabilitation 

Edward E. Gordon, a.b., m.d., Assistant Professor of 
Clinical Physical Medicine and Rehabilitation 

Bruce B. Grynbaum, m.d., Assistant Professor of Clinical 
Physical Medicine and Rehabilitation 

Eugene J. Taylor, b.s.(educ.), a.m., Assistant Professor 
of Clinical Physical Medicine and Rehabilitation 

Samuel E. Bilik, m.d., Associate Clinical Professor 

John D. Currence, b.s., m.d., Associate Clinical Professor 

Arthur S. Abramson, b.s., m.d.,c.m. [mcgill], Assistant 
Clinical Professor 

Harold Brandaleone, b.s., m.d., med.sc.d., Assistant 
Clinical Professor of Medicine {Assigned to Rehabili- 
tation) 

Leo Dobrin, a.b., m.d., Instructor 

Dominic A. Donio, b.s., m.d., Instructor 

Vera S. Emanuel, a.b. [south africa], m.d.,ch.b. [wit- 



watersrand], Instructor in Pediatrics (Assigned to 
Physical Medicine and Rehabilitation) 

Gerald J. Friedman, b.s., m.d., Instructor 

Irving M. Friedman, a.b., m.s., Instructor 

Morris Grayson, b.s.; m.d. [Lausanne], Instructor in 
Psychiatry (Assigned to Physical Medicine and Reha- 
bilitation) 

Edith L. Kristeller, m.d., Instructor 

Edward J. Lorenze, m.d., Instructor 

Morton Marks, a.b., m.d., Instructor in Neurology (As- 
signed to Physical Medicine and Rehabilitation) 

Michael Miller, B.s., m.d., Instructor 

Eugene Moskowitz, b.s.; m.d. [basel], Instructor 

Herbert F. Mulholland, b.s., m.d., Instructor 

Seymour H. Rinzler, a.b., m.d., Instructor 

Samuel S. Sverdlik, b.s., m.d., Instructor 

Henry Viscardi, Jr., B.s., ll.b., Instructor 

Lawrence H. Wisham, B.s., m.d., Instructor 

William Woolner, a.b., m.d., Instructor 

Joseph Levi, b.s., a.m., ph.d., Clinical Instructor in Med- 
ical Psychology (Assigned to Physical Medicine and 
Rehabilitation) 

Henry Brown, b.s., m.d., Assistant 

Klaas Smidt, m.d. [leiden], Assistant 

Muriel R. Benton, a.b., m.d., Clinical Assistant in Psy- 
chiatry (Assigned to Physical Medicine and Rehabili- 
tation) 

Stanley Berenstein, b.s., m.d., Fellow 

Anthony L. Brittis, a.b., m.d., Fellow 

Karl E. Carlson, a.b., m.d., Fellow 

A. Bernice Clark, a.b., m.d., Fellow 

Anna Kara, m.d. [Montreal], Fellow 

Philip R. Lee, a.b., m.d., Fellow 

Judith Rosenschein, a.b., m.d., Fellow 



Given under the direction of Professor Howard A. 
Rusk and staff. 

This course is repeated as 7310-B, January 12 
through February 6, 1953. Fee $100.00. 

731 1-A. PHYSICAL MEDICINE AND 
REHABILITATION 

An intensive ten-day course for specialists in physi- 
cal medicine and rehabilitation, July 14 through 25, 
1952. Includes methods for evaluation and practical 
training of patients with physical disabiiities. 

Given under the direction of Professor Howard A. 
Rusk and staff. Tuition $75.00. 



7312-A. SEMINAR ON THE REHABILITA- 
TION OF CHILDREN 

An intensive full-time, five-day course, October 20 
through 24, 1952, for general practitioners and pedia- 
tricians. Designed to give a picture, through lectures, 
demonstrations, clinics, and Conferences, of the Organ- 
ization, administration, Integration, equipment, the- 
ory, and practice of a pediatric rehabihtation service. 

Given under the direction of Professor Howard A. 
Rusk and staff. Tuition $40.00. 

This course is repeated as 7312-B, January 19 
through 23, 1953, and as 7312-C, April 20 through 
24, 1953. 

Rehabilitation 



tm 



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V 



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738-A. PHYSICAL MEDICINE AND REHA- 
BILITATION (GRADUATE COURSE) 

A nine-month, full-time course, September 29, 
1952, through June 19, 1953. Didactic and practical 
Instruction in the evaluation and treatment of physical 
disabiiities by physical, psychosocial, and vocational- 
rehabilitation procedures, the uses of the physical mo- 
dalities, and the therapy of the "third phase" of med- 
ical care. The clinical aspects of rehabilitation and 
physical medicine as they relate to internal medicine, 
surgery, and other specialties are presented in didactic 
lectures, seminars, and clinical demonstrations. 

Given at Bellevue Hospital, University Hospital, 
and at the Institute of Physical Medicine and Rehabil- 
itation under the direction of Professor Howard A. 
Rusk. This course is repeated as 738-B, January 12 
through October 10, 1953. Tuition $700.00. 



739-A. PHYSICAL MEDICINE AND 
REHABILITATION 

A twelve- or twenty-four-week course at Bellevue 
Hospital, University Hospital, and the Institute of 
Physical Medicine and Rehabilitation. Arranged by 
interview. 

Given under the direction of Professor Howard A. 
Rusk and staff. Tuition $200.00 for twelve weeks; 
$400.00 for twenty-four weeks. 

7310-A. PHYSICAL MEDICINE AND 
REHABILITATION 

A four-week, full-time course for specialists in 
physical medicine and rehabilitation, September 22 
through October 17, 1952. Includes advanced meth- 
ods of diagnosis, evaluation, practical training meth- 
ods, and program planning in hospital practice. 



i 



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44 



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1 



PHYSIOLOGY 



PHYSIOLOGY 



College of Medicine 



Homer W. Smith, a.b., sc.d., m.s.(hon.), Professor and 

Chairman of the Department 
W. Parker Anslow, Jr., b.s., ph.d., Associate Professor 
ehester W. Hampel, a.b., a.m., ph.d., Associate Professor 
Samuel Standard, m.d., Lecturer 
E. Lovell Becker, a.b., m.d., Instructor 
Preston G. McLean, m.d., Instructor 
Lot B. Page, m.d., Instructor 



Metabolism Studies in Applied Physiology 



■^m.. 



John C. Scott-Baker, m.b.,b.s.[london], Instructor 
Himansu S. Chakravarti, m.b., b.s., m.d. [calcutta], 

Fellow 
Alfred P. Fishman, a.b., m.s., m.d., Fellow 
Feiice Martignomi, m.d. [pavia], Fellow 
George A. Zak, Fellow 

Course Nos. 545-A and 5420-A & B, Normal and 
Pathological Physiology: Functional and Chemical 
Aspects (see pages 20 and 22). 



■ ■^BjJJ'''^'?-'-" '^ " 



/»•* 



•* '- j '. * 



9^ 



PREVENTIVE MEDICINE 



PREVENTIVE MEDICINE 

College of Medicine 



Henry E. Meleney, a.b., m.d., Hermann M. Biggs Pro- 
fessor and Chairman of the Department 
Donald Mainland, m.b.,ch.b., sc.d. [Edinburgh], Pro- 
fessor (Medical Statistics) 
Harry Most, b.s., m.d., med.sc.d., Professor {Tropical 

Medicine) 
Jacob H. Landes, m.d., m.p.h., Assistant Professor 
Donald V. Moore, a.b., a.m., ph.d., Assistant Professor 
Ray E. Trussell, a.b., m.d., m.p.h., Clinical Professor 
Abraham Stone, b.s., m.d., Associate Clinical Professor 
Arthur B. Robins, a.b., m.d., med.sc.d., d.p.h., Assistant 
Clinical Professor 

735-A. TROPICAL MEDICINE 

A full-time intensive course, in tropical and para- 
sitic diseases, of seven weeks' duration, January 5 
through February 20, 1953. Consists of lectures, labo- 
ratory exercises, and clinical demonstrations covering 
etiological agents, arthropod vectors, pathology, diag- 
nosis, treatment, and prevention. The diseases cov- 



Jacques M. May, b.s. [sorbonne], m.d. [paris], Lecturer 
(Geographical Medicine) 

Jack H. Sandground, b.s., m.s. [south africa], sc.d., 
Lecturer 

Arthur Schindelheim, d.d.s., Lecturer 

George Simon, m.d., Lecturer 

Harry Strusser, d.d.s., m.s. ( pub. health), L^cmrer 

Frederik Van Assendelft, physician [Amsterdam], Lec- 
turer (Tropical Medicine) 

Louis Weiner, e.e., Lecturer 

Lee F. Herrera, b.s., Instructor (Medical Statistics) 

Florence E. Ritner, Instructor (Social Service) 

Frances T. Poe, a.b., a.m., m.s., Assistant (Social Service) 

ered include infections caused by viruses, rickettsias, 
bacteria, fungi, spirochetes, protozoa, and helminthes; 
also nutritional diseases, tropical ophthalmology, 
dermatology, and sanitation, and physiological prob- 
lems of the tropics. 

Given under the direction of Dr. Harry Most and 
staff. Tuition $300.00. 

Laboratory Exercise in Tropica! Medicine (Schistosomiasis) 




«^s# 







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X 



PSYCHIATRY AND NEUROLOGY 



PSYCHIATRY AND NEUROLOGY 

College of Me die ine 

S. Bernard Wortis, a.b., m.d., Lucius N. Littauer Pro- 
fessor of Psychiatry, Professor of Neurology and 
Chairman of the Department 



Psychiatry 



Morris Herman, b.s., m.d., Menas S. Gregory Professor 
of Clinical Psychiatry 

Lauretta Bender, s.S., a.m., m.d., Professor of Clinical 
Psychiatry 

Lewis L Sharp, s.S., m.d.,c.m. [mcgill], Associate Pro- 
fessor of Clinical Psychiatry 

Marvin Stern, d.s., m.d., Assistant Professor 

Hans L. Teuber, ph.d., Assistant Professor ( Experi- 
ment al Psychology) 

John Frosch, s.S.; m.d. [bern], Assistant Professor of 
Clinical Psychiatry 

James F. Garrett, a.b., a.m., ph.d., Assistant Professor 
of Clinical Psychology (Assigned to Physical Medi- 
cine and Rehabilitation) 

Florence Halpern, a.b., a.m., ph.d., Assistant Professor 
of Clinical Psychology 

Thomas K. Davis, a.b., m.d., Clinical Professor of 
Neuropsychiatry 

Louis Hausman, a.b., m.d., Clinical Professor of Neuro- 
psychiatry 

Philip R. Lehrman, m.d., Clinical Professor 

Benjamin Apfelberg, m.d., Associate Clinical Professor 

John H. Taterka, m.d. [Breslau], Associate Clinical 
Professor 

David Wechsler, a.b., a.m., ph.d., Associate Clinical 
Professor of Medical Psychology 

Gustav Bychowski, m.d. [Zürich], Assistant Clinical 
Professor 

David J. Impastato, a.b., m.d., Assistant Clinical Pro- 
fessor 

Sidney Klein, b.s., m.d., Assistant Clinical Professor 

Meyer H. Maskin, a.b., m.b., m.d., Assistant Clinical 
Professor 

Bela Mittelmann, m.d. [german univ., prague], Assist- 
ant Clinical Professor 
Joseph W. Owen, m.d., Assistant Clinical Professor 
Arnold Z. Pfeffer, b.s., m.s., m.d., Assistant Clinical 
Professor 

Charles B. Thompson, a.b., m.d., Assistant Clinical 
Professor 

Helen Thompson, a.b.. a.m., ph.d., Assistant Clinical 
Professor of Medical Psychology (Assigned to Pedi- 
atrics) 

Joseph Wortis, a.b.; m.d. [vienna], Assistant Clinical 
Professor 

Zuleika Yarrell, m.d., Assistant Clinical Professor 
Frances C. Macgregor, a.b., a.m., Research Associate in 
Sociology (Psychiatry) 

Elsa Bay, b.s., Instructor (Psychiatric Social Work) 



Morris Grayson, b.s.; m.d. [Lausanne], Instructor (As- 
signed to Physical Mediane and Rehabilitation) 
Ruth M. McGuire, b.s., m.s., Instructor in Psychiatric 

Social Work 
Sadi Oppenheim, a.b., a.m., Instructor in Medical Psy- 
chology 
Earle Saxe, b.s., m.d., Instructor 
Isidor Bernstein, a.b., m.d., Clinical Instructor 
Saul H. Fisher, b.s., m.d., Clinical Instructor 
L Peter Glauber, m.d., Clinical Instructor 
Daniel L. Goldstein, b.s., m.d., Clinical Instructor 
Joseph Levi, b.s., a.m., ph.d., Clinical Instructor in 
Medical Psychology (Assigned to Physical Medicine 
and Rehabilitation) 
Joseph H. Merin, b.s., m.d., Clinical Instructor 
Emanuel Messinger, a.b., m.d., Clinical Instructor 
Edith Nachmansohn, m.d. [berlin], Clinical Instructor 
Leo L. Orenstein, b.s., m.d., Clinical Instructor 
Lilly Ottenheimer, Clinical Instructor 
Selig J. Ross, B.S., m.d., Clinical Instructor 
Dora Schaffer, m.d. [berlin], Clinical Instructor 
Howard H. Schlossman, m.d., Clinical Instructor 
Rubin L. Siegel, b.s., Clinical Instructor 
Archie Silver, b.s., m.d., Clinical Instructor 
Kona Simon, b.s., m.d. [vienna], Clinical Instructor 
Alexander Thomas, b.s., m.d., Clinical Instructor 
Montague Ullman, b.s., m.d., Clinical Instructor 
B. Frank Vogel, b.s., m.d. [paris], Clinical Instructor 
Theodore S. Weiss, m.d., Clinical Instructor 
Paul Zimmering, a.b., m.b.,ch.b. [Bristol], Clinical 

Instructor 
Marvin L. Blumberg, a.b., m.d., Assistant 
John A. Frank, b.s., m.d., Assistant 
Irving L. Bauer, a.b., m.d., Clinical Assistant 
Muriel R. Benton, a.b., m.d., Clinical Assistant (As- 
signed to Physical Medicine and Rehabilitation) 
Seymour Berg, a.b., m.d., Clinical Assistant 
Albert Bryt, m.d. [paris], Clinical Assistant 
John R. Gates, Jr., b.s., m.d., Clinical Assistant 
Abraham S. Effron, a.b., m.b. [belfast], Clinical 

Assistant 
Aaron Esman, m.d., Clinical Assistant 
Charlotte Feibel, Clinical Assistant in Medical Psy- 
chology 
Barbara Fish, m.d., Clinical Assistant 
Alfred M. Freedman, a.b., m.b., m.d., Clinical Assistant 
David B. Friedman, a.b., m.d., Clinical Assistant 
*Herman P. Gladstone, a.b., m.d., Clinical Assistant 
Harry Kosovsky, a.b., m.d., Clinical Assistant 
Malvina W. Kremer, a.b., a.m., m.d., Clinical Assistant 
John J. Macbride, a.b., m.d., Clinical Assistant 
Warren J. Muhlfelder, m.d. [basel], Clinical Assistant 



48 



irr^cif^^y».'' ^^ 



PSYCHIATRY AND NEUROLOGY 



Alfred H. Rifkin, b.s., m.d., Clinical Assistant 

Joseph E. Rubinstein, a.b., m.d.,c.m. [mcgill], Clinical 

Assistant 
John B. Scanlan, b.s., m.d., Clinical Assistant 
Bernard H. Shulman, a.b., m.d. [Edinburgh], Clinical 

Assistant 
Leonard R. Sillman, b.s., m.d., Clinical Assistant 
Sylvia B. Simon, a.b., m.d. [vienna], Clinical Assistant 
Harry F. Tashman, m.d., Clinical Assistant 
James M. Toolan, a.b., m.d., Clinical Assistant 
George J. Weinstein, m.d., Clinical Assistant 
Herbert Wieder, b.s., m.d., Clinical Assistant 
Edith Wladkowsky, b.s., Clinical Assistant in Medical 

Psychology 
Arthur Zitrin, b.s., m.s., m.d., Clinical Assistant 
Dorothy Colodny, a.b., a.m., m.d., Fellow 
Paul Dince, m.d., Fellow 
Richard C. Robertiello, a.b., m.d., Fellow 
Jerome Silverman, a.b., m.d., Fellow 

Neurology 
Samuel Brock, m.d., Professor 
Morris B. Bender, b.s., m.d., Professor of Clinical 

Neurology 
Bernhard Dattner, J.D., m.d. [vienna], Clinical Professor 
Alexandra Adler, m.d. [vienna], Assistant Clinical Pro- 
fessor 
David J. Flicker, b.s., m.d., Assistant Clinical Professor 
Israel S. Freiman, b.s., m.d., Assistant Clinical Pro- 
fessor 

645-A. NEUROLOGY (GRADUATE COURSE) 

Training in neurology is given starting September 
29, 1952. This program for qualified physicians in- 
cludes residency training in neurology and in the 
neurological aspects of medicine. Includes ( 1 ) clinical 
neurology, (2) the basic neurologic sciences (neu- 
roanatomy, neurophysiology ) , (3) measurement 
methods in neurology— including X-ray diagnosis, 
neuro-ophthalmology, and psychometric testing 
methods, (4) child neurology, (5) techniques and 
methods of examination and treatment, (6) rehabili- 
tation procedures for neurologic disabilities. Partici- 
pation is required in case presentations, seminars, 
clinical Conferences, and survey of pertinent literature. 
Each candidate is required to participate in some clini- 
cal or laboratory investigation. The course is designed 
to Cover one academic year; however, two additional 
years devoted to a neurologic residency in an ap- 
proved hospital is recommended. 

Given at Bellevue Hospital, University Hospital, 
and Goldwater Memorial Hospital under the direction 
of Professor S. Bernard Wortis. Tuition $700.00. 



Max Helfand, m.d., Assistant Clinical Professor 
Ira S. Ross, a.b., m.d., Assistant Clinical Professor 
Morton Marks, a.b., m.d., Instructor (Assigned to Phys- 
ical Medicine and Rehabilitation) 
Morton Nathanson, a.b., m.d., Instructor 
Alvin Robins, m.d., Instructor 
Ernest V. Altman, Clinical Instructor 
Francis C. Ansanelli, b.s., m.d., Clinical Instructor 
Thomas E. Bamford, Jr., a.b., m.d., med.sc.d., Clinical 

Instructor 
George S. Cattanach, a.b., m.d., Clinical Instructor 
Lawrence H. Gahagan, b.s., a.m., ph.d., m.d., Clinical 

Instructor 
Lawrence I. Kaplan, a.b., m.d., Clinical Instructor 
Joachim Luwisch, m.d. [erlangen], Clinical Instructor 
Russell G. Mac Robert, m.d. [western ontario, 

TORONTO], Clinical Instructor 
Arthur W. Schappell, a.b.(chem.), m.d., Clinical 

Instructor 
Mortimer F. Shapiro, a.b., m.d., Clinical Instructor 
John L. Simon, a.b., m.d., Clinical Instructor 
Joseph A. Winn, m.d. [charles univ., prague], Clinical 

Instructor 
Philip S. Bergman, a.b., m.d., Assistant 
Gustave G. Gordon, m.d. [bern], Clinical Assistant 
Martin A. Green, b.s., m.d., Clinical Assistant 
Elias Savitsky, b.s., m.d., Clinical Assistant 
Walter Sencer, b.s., m.d., Fellow 
♦Leave of absence, military service. 

649-A. PSYCHIATRY (GRADUATE COURSE) 

Training in psychiatry is given September 29, 1952, 
through June 19, 1953. This program for qualified 
physicians includes residency training in psychiatry 
and in the psychodynamic aspects of medicine. Inr 
cludes study pf (1) clinical psychiatry, (2) the basic 
Psychiatric sciences (study of the social, cultural, en- 
vironmental, and personal psychodynamic factors in 
health and illness), (3) the basic neurologic sciences, 
(4) psychosomatics, (5) measurement methods in 
psychiatry (both psychologic and physiologic ) , (6) 
child psychiatry, (7) techniques and methodology of 
interview and therapy, (8) medicolegal aspects of 
psychiatry. Participation is required in case presenta- 
tions, Seminars, clinical Conferences, and survey of 
pertinent literature. Each candidate is required to par- 
ticipate in some clinical or laboratory investigation. 
This is a full-time course designed to cover one aca- 
demic year; however, two additional years devoted to 
a Psychiatric residency in an approved hospital is 
recommended under the direction of Professor S. Ber- 
nard Wortis. Tuition $700.00. 



49 



PSYCHIATRY AND NEUROLOGY 



641-A. PSYCHIATRIC AND NEUROLOGIC 
PROBLEMS IN GENERAL PRACTICE 

A part-time course of three weeks' duration, 9 a.m. 
to 12 m., Mondays through Saturdays, January 5 
through 24, 1953. Covers the common Psychiatric 
Problems seen in general practice. Problems of etiol- 
ogy, diagnosis, and methods of management and treat- 
ment are stressed. 

Given under the direction of Professor S. Bernard 
Wortis. Maximum class 12. Tuition $100.00. 

642-A. ELECTROENCEPHALOGRAPHY 

A part-time course of eight weeks' duration, four 
hours each day, by arrangement, Mondays through 
Saturdays. Instruction in the general principles of 
electroencephalography in general medical, Psychi- 
atric, and neurologic disorders. The Student partici- 
pates in the recording and reading of electroen- 
cephalographic tests. 

Maximum class 6. Tuition $300.00. 

643-A. TREATMENT METHODS IN 
PSYCHIATRY 

A part-time course of eight weeks' duration, 9 a.m. 
to 12 m., Mondays through Saturdays, January 12 
through March 7, 1953. Includes instruction in, and 
critical review of, the physiologic, pharmacologic, 
electrical, and psychodynamic treatment methods. 
Open only to physicians who have had previous medi- 
cal and Psychiatric training acceptable to the depart- 
ment of psychiatry. 

Given under the direction of Professor S. Bernard 
Wortis. Tuition $250.00. 

644-A. NEUROANATOMY AND NEUROPHYS- 
lOLOGY 

A part-time basic science course of twelve weeks' 
duration on the structure and function of the nervous 
System. The course is held three mornings a week, by 
arrangement, 8:30 a.m. to 12 m., September 22 
through December 13, 1952. 

Given under the direction of Professor S. Bernard 
Wortis. Maximum class 30. Tuition $250.00. 



646-A. PSYCHIATRY IN THE PRACTICE OF 
MEDICINE AND PEDIATRICS 

A full-time, three months' course in psychiatry for 
internists and pediatricians^ Additional basic three 
months' periods of continued and advanced work can 
be arranged. The subjects covered include etiology, 
symptomatology, dynamics, and therapy in behavior 
disorders, neuroses, psychoses, and organic brain dis- 
eases in children and adolescents. In addition to lec- 
tures and seminars, there is daily practical work with 
patients. Intended to give the intemist and pediatri- 
cian an orientation to Psychiatric problems in their 
respective fields. Enrollment on various dates by ar- 
rangement. 

Tuition $300.00 for each three months' period. 

647-A. PSYCHIATRY AND NEUROLOGY 

A twelve-week, full-time course, September 22 
through December 13, 1952, in psychiatry and 
neurology. The subjects covered include clinical psy- 
chiatry, clinical neurology, therapy, psychosomatic 
Problems, neuroanatomy, neurophysiology, neuro- 
pathology, X-ray diagnosis, electroencephalography, 
and other related subjects. 

Early application, on a special and regulär form 
for registration, is recommended because of the lim- 
itr-d enrollment that can be accommodated. Preference 
L given to applicants who have had previous approved 
Psychiatric and neurologic training. 

Tuition $300.00. 

648-A. PSYCHOLOGY AND 
PSYCHODYNAMICS 

A three months', part-time course, hours by ar- 
rangement, Mondays through Saturdays, Septem- 
ber 22 through December 13, 1952, in the structure 
and development of normal personality; the theory 
and use of psychometric testing methods; and study 
of the interrelations of sociology, cultural anthropol- 
ogy, social work, religion, and the law with psychi- 
atry. Medical and social psychology are considered 
from the psychodynamic and physiologic aspects. 

Given under the direction of Professor S. Bernard 
Wortis. Maximum class 6. Tuition $200.00. 



Clats In Neurology— Emphasis Is Placed 
on Visual Aids in All Departments 



50 




MimSm 



mgT 



RADIOLOGY 



RADIOLOGY 



RADIOLOGY 



Professor and Chairman of the Department (to be 
announced) 

Milton Friedman, m.d., Associate Professor oj Clinical 
Radiology 

Maxwell H. Poppel, m.d., Associate Professor af Clinical 
Radiology 

Ira I. Kaplan, b.s., m.d., Clinical Professor 

Henry K. Taylor, m.d., Clinical Professor 

Arthur J. Bendick, m.d., Associate Clinical Professor 

Francis H. Ghiselin, a.b., m.d., Associate Clinical Pro- 
fessor 

George P. Robb, a.b., m.d., Associate Clinical Professor 
Sidney Rubenfeld, b.s., m.d., Associate Clinical Pro- 
fessor 

Francis F. Ruzicka, Jr., a.b., m.d., Associate Clinical 
Professor 

C. Wadsworth Schwartz, ph.b., m.d., Associate Clinical 

Professor 
Samuel L. Beranbaum, a.b., m.d. [Toronto], Assistant 

Clinical Professor 

Alexander J. S. Chilko, m.d. [Budapest], Assistant Clin- 
ical Professor 

Harold G. Jacobson, b.s., m.b., m.d., Assistant Clinical 
Professor 

Morris Kaplan, m.d., Assistant Clinical Professor {Radia- 
tion Therapy) 

Bernard Kurz, m.d., Assistant Clinical Professor 

651-A. DIAGNOSTIC RADIOLOGY FOR GEN- 
ERAL PRACTITIONERS 

A part-time course of thirty-two weeks' duration, 
8 to 10 p.m., Wednesdays, October 1, 1952, tlirough 
JVIay 6, 1953. Emphasis is placed on the diagnosis of 
diseases of the heart, lungs, stomach, kidneys, and 
bones. 

Maximum class 20. Tuition $100.00. 
This course is repeated as 651-B, 2 to 4 p.m., Fri- 
days, October 3, 1952, through May 8, 1953. 

652-A. DIAGNOSTIC RADIOLOGY 

A part-time course of twelve weeks' duration, 4 to 
6 p.m., Mondays, Wednesdays, and Fridays, Septem- 
ber 15 through December 5, 1952. Designed for the 
general practitioner in medicine. Consists of lectures, 
practica] demonstrations, and Conferences covering 
the physical principles underlying roentgenology, 
basic normal X-ray anatomy, the principles and prac- 
tice of fluoroscopy, and the application of X-ray diag- 
nosis to the study of fractures, bone lesions, diseases 
of the joints, lungs, heart, brain, gastrointestiml tract, 
gall bladder, urinary tract, and the mastoid and 
sinuses. 



Frederick H. McKee, a.b., m.d., Assistant Clinical Pro- 
fessor (Radiation Therapy) 

Rieva Rosh, physician [kharkov], Assistant Clinical 
Professor 

Irving Schwartz, b.s., m.d., Assistant Clinical Professor 

Jesse D. Stark, a.b., m.d., Assistant Clinical Professor 

Eimer M. Claiborne, m.d., Lecturer 

Edgar N. Grisewood, a.b., a.m., Lecturer in Radiology 
(X-Ray Physics) 

Hans R. Sielman, m.d. [munich], Lecturer 

Anthony A. Blasi, a.b.; m.d. [rome], Instructor 

Stanley H. Craig, b.s.; m.d. [basel], Instructor 

Lawrence A. Davis, a.b., m.d., Instructor 

Lewis J. Friedman, m.d., Instructor 

Samuel T. Herstone, a.b., m.d., Instructor 

Howard J. Hutter, m.d., Instructor 

Max Miller, b.s., m.d. [vienna], med.sc.m., Instructor 

Eleanor Oshry, b.s. (physics), Instructor (Radiological 
Physics) 

Herbert S. Sharlin, a.b., m.d., Instructor 

Harry Weaver, a.b., m.d., Instructor 

Constantino Zaino, b.s., m.d., Instructor 

Joseph Zausner, b.s.; m.d. [vienna], Instructor 

Alfred J. Bernstein, b.s.; m.b.,ch.b. [st. Andrews], Clini- 
cal Instructor 

Abraham Geffen, a.b., m.d., Clinical Instructor 

Joseph J. Sher, b.s., m.d., Clinical Instructor (Derma- 
tology) 

Maximum class 20. Tuition $100.00. 
This course is repeated as 652-B, February 16 
through May 8, 1953. 

653-A. RADIOLOGY, BASIC SCIENCES 

A full-time course of nine months' duration, Sep- 
tember 29, 1952, through June 19, 1953. Includes 
anatomy, radiophysics, biochemistry, physiology, bac- 
teriology, pathology, and the principles and applica- 
tion of radiobiology. 

Given under the direction of Dr. Milton Friedman. 
Tuition $700.00. 

654-A. RADIOBIOLOGY 

A part-time course of twenty sessions, 5 to 7 p.m., 
Thursdays, January 29 through June 11, 1953. Open 
to postgraduate students in radiation therapy and also 
to practicing radiologists. 

Consists of lectures and seminars and is designed 
to bridge the gap between radiation physics and clin- 
ical radiation therapy, by giving the Student a back- 
ground of the biological as well as physical effects of 
irradiation. After a review of the biological, physical, 



chemical, and histological effects of radiation on 
tissue, the application of these basic phenomena to 
practica] radiation therapy is discussed. Radiation 
genetics, recovery phenomena, time-dose studies, and 
gamma roentgen dosage System for radium therapy 
are reviewed. Problems are assigned which entail 
directed outside reading to amplify the lectures. 

Given under the direction of Dr. Milton Friedman. 
Maximum class 20. Tuition $75.00. 

655-A. RADIOPHYSICS 

A part-time course of fifteen sessions, 9 to 10:30 
a.m., Tuesdays, October 21, 1952, through Febru- 
ary 3, 1953, consisting of didactic lectures and prac- 
tica] demonstrations. Includes a consideration of the 



basic concepts of electricity, magnetism, radiation; 
the production and measurement of X rays; natural 
and artificial radioactivity, including dosage deter- 
minations. 

Given under the direction of Dr. Milton Friedman. 
Maximum class 20. Tuition $75.00. 

656-A. DIAGNOSTIC RADIOLOGY 

An intensive five-day course, füll time, June 15 
through 19, 1953, consisting of lectures, practical 
demonstrations, and Conferences covering X-ray diag- 
nosis, diseases of the heart, lungs, and gastrointestinal, 
urinary, and biliary tracts. 

Tuition $50.00. 

Practica! Seminar in Radiology 



52 



mm 



^ 



SURGERY 



SURGERY 



J. William Hinton, m.d., Professor and Chairman of the 

Department 
L. Corsan Reid, m.d.,c.m. [mcgill], Professor of Ex- 

peri mental Surgery 
R. Franklin Carter, b.s., m.d., Professor of Clinical 

Siir^ery 
Robert H. Kennedy, a.b., m.d., Professor of Clinical 

Surgery 
Arthur S. McQuillan, a.b., m.d., Professor of Clinical 

Surgery 

Herbert Willy Meyer, a.b., m.d., Professor of Clinical 
Surgery 

Walter W. Fischer, m.d., Associate Professor of Clinical 
Surgery 

S. Arthur Localio, a.b., m.d., med.sc.d., Associate Pro- 
fessor of Clinical Surgery 

Jere W. Lord, Jr., a.b., m.d., Associate Professor of 
Clinical Surgery 

Louis R. Slattery, a.b., m.d., Associate Professor of Clin- 
ical Surgery 

Robert T. Crowley, m.d., m.s. (surgery), med.sc.m., 
Assistant Professor of Clinical Surgery 

David Lyall, b.s., m.d., Assistant Professor of Clinical 
Surgery 

Charles G. Neumann, a.b., m.d., Assistant Professor of 
Clinical Surgery 

Louis M. Rosati, b.s., m.d., Assistant Professor of Clin- 
ical Surgery 

George M. Saypol, b.s., m.d., Assistant Professor of 

Clinical Surgery 
Alexander Zimany, a.b., m.d., Assistant Professor of 

Clinical Surgery 

Philip A. Zoller, m.d., Assistant Professor of Clinical 

Surgery 
Bradley L. Coley, a.b., m.d., Clinical Professor 
Lester Blum, a.b., m.d., Associate Clinical Professor 
Lester Breidenbach, b.s., m.d., Associate Clinical Pro- 
fessor 

Harold E. Clark, a.b., m.d., Associate Clinical Professor 



665-A. SURGERY (GRADUATE COURSE) 

Designed for one academic year, September 29, 
1952, through June 19, 1953, of fuU-time study to 
precede or follow two or more years of surgical resi- 
dency in an approved hospital. In this course approxi- 
mately three quarters of the time is devoted to basic 
sciences while the remainder is alloted to clinical sub- 
jects. The basic sciences include anatomy, physiology, 
biochemistry, bacteriology, pharmacology, surgical 
pathology, and experimental surgery. Clinical teach- 
ing is correlated with the basic sciences and is con- 
ducted as informal round-table Conferences. These 
Conferences are devoted to general surgery, tumor 



Norman L. Higinbotham, m.d.,c.m. [mcgill], Asso- 
ciate Clinical Professor 

Miguel Grausman Elias, B.s., m.d., Associate Clinical 
Professor 

Walter D. Ludlum, Jr., a.b., m.d., Associate Clinical 
Professor 

Sigmund Mage, a.b., b.s., m.d., Associate Clinical Pro- 
fessor 

Herbert F. Newman, a.b., m.d., Associate Clinical Pro- 
fessor 

* Robert T. Findlay, m.d., Assistant Clinical Professor 
William T. Medl, a.b., m.d., Assistant Clinical Professor 
William Batiuchok, a.b., m.d., Instructor 

Frank S. Butler, a.b., m.d., Instructor 
Jameson L. Chassin, b.s., m.d., Instructor 
Donald A. Davis, b.s., m.d., Instructor 
Stephen L. Gumport, a.b., m.d., Instructor 
Hector A. McDougall, b.s., m.d.,c.m. [mcgill], 

Instructor 
Carl S. Oakman, a.b., m.d., Instructor 
Carl W. Roessel, a.b., m.d., Instructor 
Charles F. Schetlin, a.b., m.d., Instructor 
Reynold E. Church, b.s., m.d., Clinical Instructor 
Lee Gillette, a.b., m.d., Clinical Instructor 
Gabriel P. Seley, m.d., Clinical Instructor 
Meyer M. Stone, ch.e., m.d., Clinical Instructor 
Louis Venet, b.s., m.d., Clinical Instructor 
Harry Chasserot, a.b., m.d., Assistant 
Frederick W. Finn, b.s., m.d., Assistant 
James K. Keeley, a.b., m.d., m.s. (surgery), Assistant 
Rockwood Keith, b.s., m.d., m.s. (med.), med.sc.d., 

Assistant 
Jane A. La Fetra, b.s. (med. tech.), Assistant 
Graham C. Newbury, m.d., Assistant 
Caspare A. Salvia, a.b., m.d., Assistant 
Hugh E. Stephenson, Jr., b.s., m.d., Assistant 

* Peter William Stone, m.d., Assistant 
Harry B. Underwood, b.s., m.d., Assistant 
Jerrold von Wedel, m.d., Assistant 

*Leave of absence, armed forces. 

surgery, pediatric surgery and the surgery of trauma. 
Diagnostic roentgenology is given as part of the 
course. Library periods are assigned for study of 
surgical literature. 

Given under the direction of Professor J. William 
Hinton. Tuition $700.00. 

660-A. ANATOMY AND PHYSIOLOGY OF 
THE AUTONOM IC NERVOUS SYSTEM AND 
THEIR CLINICAL APPLICATION 

A full-time, one-week course, January 19 through 
24, 1952, devoted to the anatomy and physiology of 
the autonomic nervous System. Anatomical demon- 



54 



mtm 



li^^Mto 



SURGERY 



strations and prosections are correlated with lectures 
and Conferences. The diagnostic, therapeutic, and 
surgical procedures performed upon the autonomic 
nervous system for pathologic processes are thor- 
oughly covered as well as the relation of the autonomic 
nervous system to anesthetic, endocrinologic, and psy- 
chosomatic problems. 

Given under the direction of Professor J. William 
Hinton and Dr. Joseph Pick of the department of 
anatomy. Maximum class 12. Tuition $150.00. 

661-A. REVIEW OF GENERAL SURGERY 
(FOR SPECIALISTS) 

A full-time course of four weeks' duration for 
qualified surgeons, September 29 through October 25, 

1952. Provides advanced Instruction in general sur- 
gery by means of demonstrations, lectures, and a 
review of applied surgical anatomy on the cadaver. 
Special measures employed in the preoperative and 
postoperative care of patients are emphasized in clin- 
ical demonstrations and lectures by specialists from 
the medical, surgical, and laboratory staffs. Differen- 
tial diagnosis and treatment are discussed and demon- 
strated in specialty clinics for the management of 
diseases of the thyroid, stomach, colon and rectum, 
biliary tract, pancreas, thorax, and cardiovascular 
System. Similar clinical demonstrations are given by 
the Tumor Service for diseases of the breast, tumors 
of the head and neck, and malignant melanoma. 
Physiological and biochemical aspects of surgical 
practice are stressed and use of antibiotics discussed. 

Given under the direction of Professor J. William 
Hinton. Maximum class 20. Tuition $300.00. 

This course is repeated as 661-B, March 30 through 
April 25, 1953. 

662-A. BASIC PROBLEMS IN CANCER THER- 
APY (FOR SURGEONS) 

A full-time course of twelve days' duration for 
qualified surgeons, January 26 through February 7, 

1953, on the basic problems of Cancer therapy. Early 
diagnosis and modern methods of surgical therapy 
are discussed in didactic lectures and case demonstra- 
tions. The operative technique of block lymph-node 
dissections and radical surgery for Cancer of the head, 
neck, thorax, breast, abdomen, and extremities is 
stressed in cadaver demonstrations. 

Given under the direction of Dr. Herbert Willy 
Meyer. Maximum class 20. Tuition $200.00. 

663-A. RECENT ADVANCES IN SURGERY 

A full-time course of two weeks' duration, Septem- 
ber 8 through 20, 1952, consisting of didactic lectures 



and demonstrations that cover the recent advances in 
general surgery stressing physiological and biochem- 
ical considerations. Emphasis is placed on recent 
advances in surgery of the thyroid, thorax, and cardio- 
vascular System, including portal hypertension and 
cirrhosis of the liver. The physiological background 
of gastric surgery and vagotomy in the management 
of peptic ulcer is stressed, as well as the biochemical 
and physiological advances related to surgery of the 
intestines, biliary tract, and pancreas. The extended 
concepts of Cancer surgery and lymphatic drainage are 
covered from the pathological and anatomical stand- 
points. The diseases of the autonomic nervous system 
are covered and the physiological basis of surgical 
procedures on this system emphasized. 

Given under the direction of Professor J. William 
Hinton. Tuition $200.00. 

664-A. TRAUMA (EXCLUDING FRACTURES) 
(FOR SURGEONS) 

A full-time course of five and one-half days' dura- 
tion, December 1 through 6, 1952. Emphasis is placed 
on training in the correct methods of suturing tendons, 
nerves, blood vessels, and intestines, and in the prepa- 
ration and application of skin grafts and flaps in the 
surgical laboratory. In preparation for this, the morn- 
ings are spent in presentations of the indications for 
and value of these procedures. 

Given under the direction of Dr. Robert H. Ken- 
nedy. Maximum class 30. Tuition $125.00. 

666-A. DIAGNOSIS AND TREATMENT OF 
TRAUMA 

A full-time course of six days' duration, Decem- 
ber 8 through 13, 1952. Planned for those physicians 
who are now, or expect to be, concerned with indus- 
trial or civilian injuries of all types. It is also aimed 
at preparing physicians for better care of injury in the 
event of civilian disaster. An intensive course of lec- 
tures and demonstrations on the care and treatment 
of the injured. Case demonstrations and ward rounds 
are held at Beekman-Downtown, Bellevue, Univer- 
sity, and Gouverneur Hospitals. 

Given under the direction of Dr. Robert H. Ken- 
nedy. Maximum class 20. Tuition $90.00. 

667-A. SURGERY OF THE HAND 

A full-time course of six days' duration, March 23 
through 28, 1953. Considers the anatomy and physi- 
ology of the band. A series of lectures and demonstra- 
tions based on the practical clinical viewpoint toward 
management, soft-tissue defects, fractures, infections, 
burns, crush injuries, tendon repair, grafts and trans- 



55 



— "^ 



SURGERY 



plants, vasomotor and tropic lesions, rehabilitation 
and reconstruction. Given at Beekman-Downtown, 
Gouverneur, Bellevue, and University Hospitals. 

Given under the direction of Dr. Robert H. Ken- 
nedy. Maximum class 20. Tuition $90.00. 

668-A. DIAGNOSIS AND TREATMENT OF 
FRACTURES AND DISLOCATIONS 

A full-time course of two weeks' duration, Febru- 
ary 2 through 14, 1953. Consists of review of current 
methods of diagnosis and treatment, lectures, demon- 
strations, ward rounds, and ambulatory clinics at 
Beekman-Downtown, Gouverneur, and Bellevue Hos- 
pitals. Includes presence at one or more bone Opera- 
tions. 

Given under the direction of Dr. Robert H. Ken- 
nedy. Maximum class 20. Tuition $125.00. 

669-A. SURGERY OF TRAUMA 

A part-time course of ten sessions, 1 to 5 p.m., 
Thursdays, April 2 through June 4, 1953, covering 
the field of trauma. Ward rounds, clinical demonstra- 
tions, follow-up clinics, round-table discussions, and 
lectures. Includes presence at one or more bone Opera- 
tions. Given at Beekman-Downtown and Bellevue 
Hospitals. 

Given under the direction of Dr. Robert H. Ken- 
nedy. Maximum class 20. Tuition $100.00. 

Physicians Learning Surgical Technique in the Laboratory 



6610-A. TRAUMA OF THE GENITOURINARY 
SYSTEM 

A part-time course of six sessions, 2 to 4 p.m., 
Tuesdays, September 9 through October 14, 1952. 
Consists of lectures and demonstrations covering the 
field of genitourinary trauma. A review is made of the 
essential anatomy, abnormal physiology and path- 
ology, diflferential diagnosis, and the principles of 
treatment. Particular emphasis is placed on the meth- 
ods of examination, including a discussion of the 
investigation of the acutely injured patient at the bed- 
side. An evaluation of the various injuries as related 
to workmen's compensation is made also. Given at 
Beekman-Downtown Hospital. 

Given under the direction of Dr. Robert H. Ken- 
nedy. Tuition $50.00. 

661 1-A. PITFALLS IN INTERNAL FIXATION 
OF FRACTURES (SPECIALISTS) 

A full-time course of six days' duration, Novem- 
ber 10 through 15, 1952. A series of lectures and 
demonstrations on the physical, chemical, and physi- 
ological characteristics of bone plates and screws; 
errors in their manufacture and in technique of appli- 
cation; intramedullary fixation and hip nailing. There 
are also Operations and case demonstrations. Given 
at Beekman-Downtown Hospital. 

Given under the direction of Dr. Robert H. Ken- 
nedy. Maximum class 20. Tuition $90.00. 




UROLOGY 



UROLOGY 



Robert S. Hotchkiss, B.s., m.d., Professor and Chairman 

of the Department 
Meredith F. Campbell, b.s., m.s., m.d., Professor 
William Delzell, a.b., m.d., Professor of Clinical Urology 
C. Travers Stepita, m.d., m.s., Professor of Clinical 

Vrolofiy 
Herbert Brendler, a.b., m.d., Assistant Professor 
Thomas F. Howley, a.b., m.d., Associate Clinical Pro- 
fessor 
Herbert R. Kenyon, a.b., m.d., Associate Clinical Pro- 
fessor 
Dean Makowski, a.b., m.d., Associate Clinical Professor 
Maximilian M. Nemser, m.d., Associate Clinical Pro- 
fessor 
George W. Slaughter, a.b., m.d., Associate Clinical Pro- 
fessor 
Seymour F. Wilhelm, b.s., m.d., Associate Clinical Pro- 
fessor 



John L. Alley, a.b., m.d.. Assistant Clinical Professor 
Alvin C. Drummond, a.b., m.s., m.d., Assistant Clinical 

Professor 
Gaetano J. Mecca, m.d., Assistant Clinical Professor 
Harry R. Newman, m.d. [Toronto], m.s., Assistant Clin- 
ical Professor 
Bernard D. Pinck, a.b.. m.d., Assistant Clinical Professor 
Alien Abrahams, b.s.. m.d.. Instriictor 
Joseph H. Marvin, b.s., b.s.s.. a.m., m.d., Instructor 
Samuel S. Newman, m.d., Instructor 
Lazarus A. Orkin, B.s., m.d., Instructor 
John M. Silberblatt, a.b.. m.d., Instructor 
Gustav Friedmann, m.d., Clinical Instructor 
Ira J. Holzman, a.b., m.d., Clinical Instructor 
Sol S. Katz, M.D. [LAUSANNE], CHnical Instructor 
Robert E. Lucey, m.d., Clinical Instructor 
Noah Meyerson, m.d.. Clinical Instructor 
Irving M. Schneider, b.s.. m.d.. Clinical Instructor 



Postgraduate study of varying duration may be 
undertaken by special arrangement on a prorata basis 
of $200.00 per month, füll time. 

672-A. UROLOGY (GRADUATE COURSE) 

A full-time course of one academic year, Septem- 
ber 29, 1952, through June 19, 1953, designed par- 
ticularly for those who intend to specialize in urology 
and who will complete their training with a residency. 
Major emphasis is placed on the basic sciences, includ- 
ing anatomy, biochemistry, bacteriology, and pathol- 
ogy. Application of the clinical science study is pre- 
sented by means of cadaver and experimental surgery, 
as well as by staff Conferences and round-table discus- 
sions. The allied clinical subjects, such as anesthesiol- 
ogy, medicine, general surgery, gynecology, and pedi- 
atrics, are presented by specialists in the respective 
fields. The purpose of the course is to give the Student 
a firm foundation in the basic sciences as well as the 
fundamentals of diagnosis and clinical management 
of Urologie Problems. In exceptional circumstances, 
the applicant may elect to pursue this course over a 
three-year period. The first year he may be in attend- 
ance for the first trimester (September to December). 
The second year he may progress to the second trimes- 
ter (January to March), and in the third year may 
complete the last trimester (April to June). 

Given under the direction of Professor Robert S. 
Hotchkiss. Tuition $700.00. 

67 1-A. ADVANCED COURSE IN UROLOGY 
(FOR SPECIALISTS) 

A full-time course of four weeks' duration, to be 
held in May or June (dates to be announced later). 



All surgical operative procedures are reviewed on the 
cadaver and in operative clinics with ward rounds for 
Instruction in preoperative and postoperative care. 
Advanced instruction in cystoscopic and urethro- 
scopic diagnosis and treatment in urography is given 
in the outpatient department. The newer aspects of 
correlated subjects such as anesthesiology, cardiovas- 
cular disease, microbiology, and renal physiology are 
presented. Topics related to recent advances in 
urology are reviewed. 

Given under the direction of Professor Robert S. 
Hotchkiss. Tuition $175.00. 

564-A. INFERTILITY 

A three-day, full-time course given jointly by the 
department of urology and the department of obste- 
trics and gynecology, December 8 through 10, 1952. 
Problems of sterility are presented as related to both 
husband and wife. Methods of diagnosis and treatment 
are presented by lectures, outpatient demonstrations, 
and laboratory techniques. 

Tuition $40.00. 

674-A. REFRESHER COURSE IN BASIC 
UROLOGY 

A one-week, full-time course, November 10 
through 15, 1952, devoted to anatomical-surgical 
demonstrations on the cadaver. A review of embry- 
ology, pathology, and physiology of the genitourinary 
System. 

Given under the direction of Professor Robert S. 
Hotchkiss. Tuition $60.00. 



57 



1^-^ 



General Information 



POST-GRADUATE MEDICAL SCHOOL 



The New York University Post-Graduate Medical 
School was founded on December 1, 1947, through 
the consolidation of the New York Post-Graduate 
Medical School and the Postgraduale Division of the 
College of Medicine. 

The New York Post-Graduate Medical School 
and Hospital was incorporated in 1882 and chartered 
by the State in 1886. The College of Medicine of New 
York University oflfered postgraduate studies first in 
1914 and, because of the large number of physician 
veterans interested in retraining, organized the Post- 
graduate Division of the College of Medicine in 1945. 
This was made possible through a three-year grant 
from the W. K. Kellogg Foundation. 

The Consolidated Post-Graduate Medical School 
through its clinical Services offers courses in practi- 
cally all fields of medicine and surgery for the general 
practitioner and the specialist. 

The present greatly expanded program has been 
made possible through the generosity of the Samuel H. 
Kress Foundation, which has made a substantial con- 
tribution for a ten-year period for the support of the 
Post-Graduate Medical School. 

The following hospitals participate in the graduate 
and postgraduate program of the school: 

Bellevue Hospital, the oldest of 26 municipal hos- 
pitals owned and operated by the Department of Hos- 
pitals of New York City, was founded in 1736 and 
was given its present name in 1816. It accommodates 
over 3,000 patients, primarily those with acute disease. 
Yearly admissions average 65,000. The hospital is 
organized in four divisions, the fourth being the teach- 
ing division of the Post-Graduate Medical School. 

Beekman-Downtown Hospital, a voluntary hospital 
of 180 beds, is known for its large number of admis- 
sions of patients with acute surgical conditions, par- 
ticularly of traumatic origin. 



Beth Israel Hospital, a voluntary Institution of 382 
beds and 80 bassinets. 

Goldwater Memorial Hospital for Chronic Dis- 
eases. The New York University Division has 750 
beds divided among medical, surgical, neurological, 
and research Services. 

Gouverneur Hospital, a municipal hospital of 200 
beds. 

Irvington House, a voluntary hospital of 103 beds 
located at Irvington-on-Hudson, New York. The 
Institution specializes in the care of children with rheu- 
matic fever and rheumatic heart disease. 

Lenox Hill Hospital, a voluntary hospital of 600 
beds. 

A'^H' York Eye and Ear Infirmary, a voluntary hos- 
pital, was the first Institution established in this coun- 
ery limited to diseases of the eye, ear, nose, and throat. 
It has 171 beds in addition to a very large outpatient 
Service. 

New York State Rehabilitation Hospital, at Haver- 
straw, New York, is a specialty hospital of 300 beds, 
which is limited to the care of children and adults with 
orthopedic conditions, as well as poliomyelitis. 

St. Vincent's Hospital is a voluntary hospital of 544 
beds. An extensive building program will increase its 
capacity to 626 beds. 

University Hospital, formerly the New York Post- 
Graduate Hospital, has been an integral part of the 
Medical Center since December 1, 1947. It has 406 
beds. 

Willard Parker Hospital, a municipal Institution of 
433 beds, is limited to the treatment of contagious dis- 
ease. In addition to the usual contagious diseases, 
there are available 100 beds for the care and study of 
patients with pulmonary tuberculosis. 

The number of beds directly affiliated with the 
Medical Center totals approximately 6,500. 



NEW YORK UNIVERSITY-BELLEVUE MEDICAL CENTER 



New York University established the Medical Cen- 
ter in 1948 in order to carry out an expanded pro- 
gram of medical education, research, and patient care. 
The Medical Center includes the College of Medicine, 
the Post-Graduate Medical School, and the twenty- 
three hospitals in which the clinical part of the pro- 
gram of the two schools is carried out. All the hospitals 
are operated by outside agencies, either municipal or 



voluntary, except the University Hospital, which is 
owned and operated by the University. By far the 
largest part of the clinical program is in Bellevue 
Hospital, in which the University has operated its 
teaching and research programs for over a Century. 
Through the facilities of the Medical Center, the 
University is now able to offer to students— undergrad- 
uate, graduate, and postgraduate— and to research 
workers one of the finest opportunities now available. 



58 



IMM 



General Information 



REGIONAL HOSPITAL PLAN 



The REGIONAL HOSPITAL PLAN provides to 
nonteaching hospitals in suburban and rural areas 
association with the teaching and research staffs of 
the Medical Center. Resident physicians of these 
affiliated hospitals have the privilege of spending an 
academic year in a graduate course at the center, with 
the tuition waived subject to the rules and regulations 
governing the Regional Plan. 

The objective of the Regional Hospital Plan is the 
improvement of the medical care in the communities 
served by the hospitals. It also provides a distinct 
broadening of the opportunities for postgraduate edu- 
cation to the practicing physicians in these areas. 

The Regional Hospital Plan is supporteä by a grant 
from the W. K. Kellogg Foundation. 

Participating hospitals as of April 1, 1952, are: 
Easton Hospital, Easton, Pennsylvania 
Fitkin Memorial Hospital, Neptune, New Jersey 
Grasslands Hospital, Valhalla, New York 
Greenwich Hospital, Greenwich, Connecticut 



Hunterdon Medical Center, Flemington, 

New Jersey* 
Meadowbrook Hospital, Hempstead, New York 
Monmouth Memorial Hospital, Long Branch, 

New Jersey 
Mountainside Hospital, Montclair, New Jersey 
New Rochelle Hospital, New Rochelle, 

New York 
Overlook Hospital, Summit, New Jersey 
St. Luke's Hospital, Newburgh, New York 
St. Vincent's Hospital, Bridgeport, Connecticut 
Vassar Brothers Hospital, Poughkeepsie, 

New York 

*Under construction. 

The Regional Hospital Plan of the Medical Center 
is administered by the Division of Affiliated and 
Regional Hospitals of which Associate Dean Clarence 
E. de la Chapelle and Associate Dean Frode Jensen 
are in Charge. 

Physicians from 27 Foreign Countries, 45 States, and 2 Territories 
Studied Last Year in the Post-Graduate Medical School 



är' j(f«''^ä;n 



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^■1^ 



General Information 




General Information 



POSTGRADUATE COURSES 



The school offers numerous postgraduate courses 
on a part-time or full-time basis in the various fields 
of medicine and surgery. These courses are designed 
to meet the needs of physicians in practice whether 
specialists or general practitioners. Whenever pos- 
sible, the school will endeavor to establish courses for 
special groups. The minimum requirements for admis- 
sion to these courses are : 

1. Graduation from a medical College, or its 
equivalent, approved by the Post-Graduate Medical 
School. 



2. Completion of an internship of at least one year 
(or nine months of the accelerated wartime schedule) 
in a hospital approved by the Post-Graduate Medical 
School, except in the case of foreign students who will 
be required to have an equivalent amount of hospital 
experience. 

All applications and inquiries concerning admission 
should be addressed to the Office of the Dean, Post- 
Graduate Medical School, 477 First Avenue, New 
York 16, N.Y. 



NEW YORK UNIVERSITY • POST-GRADUATE MEDICAL SCHOOL 

477 Jirst Avenue • ?^ew Jork i6 • "New Jork 

APPLICATION FOR POST-GRADUATE COURSES 






Last Name. 



.First Name. 



.Middle Name. 



Permanent Address. 



Age 

Attended. 



.Sex. 



.Citizenship. 



(City) 
Marital Status. 



(State) 



.Medical School from. 



.to. 



.Degree. 



HOSPITAL INTERNSHIPS OR RESIDENCIES: 

0)- 



(Name of Hospital) 
(2). 



(City) 



(State) 



.from. 
.from. 



.to. 
.to. 



(Name of Hospital) (City) (State) 

State below the nature of each of the internships or residencies (i.e., whether rotating, medical, or surgical): 

' ^~~~ (2) _ J(Use back for additional data) 

PREVIOUS GRADUATE OR POSTGRADUATE MEDICAL STUDY (List on back) 



Licensed to practice medicine in (state). ___^ 

Professional organizations or specialty board certification. 



.(year). 



.License No. 



PRESENT HOSPITAL AFFILIATION. 
Type of Practice 



(Hospital) 



(City) 



(State) 



(DateApp'd) 



(Service) 



Military Service (list on back with dates and brief indication of type of professional experience): 



I HEREBY APPLY FOR ADMISSION TO THE FOLLOWING COURSES: 

^o __ Subject. 

No._ 



.Beginning. 



.Subject- 



Date. 



.Beginning. 



Approved- 



(Signatur e of Applicant) 



GRADUATE COURSES 



Graduate courses of one year's duration at the 
Post-Graduate Medical School are offered to provide 
advanced training in medicine and surgery and also 
in the medical and surgical specialties. They may be 
taken as part of a residency training program or in 
preparation for examinations of the various specialty 
boards. The minimum requirements for admission to 
these courses are : 

1 . Graduation from a medical College approved by 
the Post-Graduate Medical School or the Council on 
Medical Education and Hospitals of the American 
Medical Association 

2. Completion of an internship of at least one year 
in a hospital approved by the Post-Graduate Medical 
School or, in the case of foreign students, an equiva- 
lent amount of hospital training 



3. Approval by the head of the department in 
which the course is to be given 

It is not possible for the committee on admissions 
to interview all candidates for admission to these 
studies. However, candidates may be requested to 
appear before the committee. 

Examinations, either written or oral or both, are 
required of Student physicians before completion of 
the graduate courses. 

The regulations governing examinations are sub- 
ject to change at any time. 

A certificate will be granted to those physicians who 
have fulfilled all the requisites of a graduate course 
of study, including the successful passing of required 
examinations. (5^^page62) 



NEW YORK UNIVERSITY • POST-GRADUATE MEDICAL SCHOOL 

477 7irst Jvenue • Tiew Jork 16 • T^ew york 

APPLICATION FOR GRADUATE COURSE 



Last Name. 



.First Name. 



.Middle Name. 



Permanent Address 

A ge Sex. 



.Citizenship. 



(City) 
Marital Status. 



(State) 



A ttended- 



.Medical School from. 



.to. 



.Degree. 



HOSPITAL INTERNSHIPS OR RESIDENCIES (Indicate whether rotating, medical, surgical, etc.): 
fj) from- . to 



(Name of Hospital) 
(2). 



(City) 



(State) 



(Name of Hospital) 
(3) 



(City) 



(State) 



.from. 

) 

.from. 



to. 



.to. 



Type. 

Type. 

-Type. 



(Name of Hospital) (City) (State) 

PRESENT HOSPITAL AFFILIATION: 

from. 

(Name of Hospital) (City) (State) 

If in practice, indicate whether general or confined to a specialty. 

Licensed 



.to. 



-Type. 



Year. 



1 HEREBY APPLY FOR ADMISSION TO THE FOLLOWING COURSE: 



No. 



.Subject. 



. Beginn ing. 



Date. 



Approved. 



The applicant must Supplement this form with: (I) transcript 
of medical College record; (2) certification of hospital intern- 
ship (and residency); (3) three letters of recommendation from 
qualified physicians; (4) applicant's photograph; (5) applicant 



(Signature of Applicant) 

for the course in surgery must furnish written assurance of a 
residency or appointment to the attending staff of an approved 
hospital following completion of the course. 



60 



61 



General Information 



he graduate courses are: 








Number 


Page 


Anesthesiology 


513-A 


8 


Dermatology and Syphi ology 


525-A 


13 


Forcnsic Medicine 


531-A 


15 


Industrial Medicine 


481-A 


16 


Medicine 


5429-A 


19 


Neurology 


645-A 


49 


Ophthalmology 


576-A 


32 



General Information 



Orthopedic Surgery 

Otorhinolaryngology 

Pediatrics 

Physical Medicine and 

Rehabilitation 
Psychiatry 
Surgery 
Urology 



Number 


Page 


581-A 


35 


593-A 


36 


6110-A 


40 


738-A 


44 


649-A 


49 


665-A 


54 


672-A 


57 



DEGREES 



Master of Science 



This degree in a designated clinical field, e.g., M.S. 
(in Ophthalmology), M.S. (in Dermatology and 
Syphilology), etc., may be awarded after the candi- 
datc has fulfillcd the following requirements: 

1. He must be or have been registered as a gradu- 
ate Student for one year in the school subsequent to 
1951 when this degree was approved by the Univer- 
sity. 

2. He must give evidence of at least two additional 
yearsof graduate training beyond the internship. Grad- 
uate training other than that obtained at the school 
must be in hospitals or institutions approved by the 
faculty. A fellowship or preceptorship may be ac- 
ceptcd in lieu of a residency but prior approval must 
be obtained by the faculty. 

3. He must submit an acceptablc thesis following 
completion of thrce years of graduate work. However, 
ycarly registration is necessary until the candidate has 
submittcd his thesis. This thesis may represent labora- 
tory or clinical invcstigation. Before the candidate is 
recommcnded for the degree, his thesis must be 
approved by a committee of readers appointed by the 
dean. 

The matriculation fee is $6.00 per year except for 
the one year spent in a graduate course at the school 
No credit will be allowed by the University toward a 
doctorate in philosophy for work done in satisfying 
the requirements of the Master of Science degree. 

Doctor of Medical Science (Med.Sc.D.) 

A physician regularly matriculated in the Post- 
Graduate Medical School may, in exceptional circum- 
stances, be recommendcd as a candidate for the degree 
of Doctor of Medical Science (Med.Sc.D.) Such a 
Student, if enrolled in one of the graduate studies 
must not only satisfactorily complete the special 
requirements of the course including examinations but 



62 



must also show unusual professional ability and excep- 
tional academic attainments. Other candidates, espe- 
cially those participating in full-time research in a 
precljnical and/or clinical department, may at the 
completion of at least one year of such work be recom- 
mcnded by the department head as a candidate for 
the advanced degree. In the event that a candidate is 
approved, he will be required to meet the following 
regulations: 

He shall spend at least three years in graduate study, 
of which at least one year shall be at the Post-Gradu- 
ate Medical School. 

A Student must maintain his matriculation in the 
Post-Graduate Medical School throughout the period 
of his candidacy for the degree. A matriculation fee 
of $6.00 is payable each year. 

A preliminary examination, conducted at least one 
year before the time the candidate will apply for the 
degree, is designed to demonstrate a comprehensive 
and accurate knowledge of the preclinical sciences as 
requisite for mastery of his special field. This examina- 
tion will be both oral and written. If the candidate 
successfully passes this examination, he will be per- 
mitted to continue his graduate work including inde- 
pendent invcstigation and the preparation of his 
thesis. It is expected that the preparation of an ac- 
ceptablc thesis will usualiy require not less than an 
academic year. The thesis must conform to regulations 
printed in a separate pamphlet obtainable from the 
dean's ofhce. 

The final examination is a defense of the thesis. 
The chairman of the examining board will submit to 
the dean, as soon as possible after the examination, 
the opinion of the committee as a whole regarding 
the candidate's qualifications for the degree. 

No candidate will be recommcnded for a degree 
until the graduation fee and all other required fees 
have been paid. These fees are due and payable on or 
before May 15. 



I 



I 



AUDIO-VISUAL METHODS AND AIDS USED BY THE DIVISION OF CARDIOLOGY 



The division of cardiology has developed, during 
the last several years, certain audio-visual methods 
that have special application in the teaching of cardio- 
vascular diseases. 

The first of these is the fluoro-demonstrator, which 
is a device using heart modeis and allows visualization 
of the Silhouette of the heart in all positions. This Sil- 
houette has all the appearances of the heart under 
the fluoroscope with the exception of pulsating 
motion. 

The classroom is equipped with ultraviolct light, 
known as "black light," which allows the use of fluo- 
rescent paints and chalks that stand out brilliantly with 
the room darkened for viewing X rays, lantern slides, 
or oscilloscopes. 

The Educational Electron Cardioscope uses a 



sixteen-inch, television-type tube on which the instan- 
taneous electrocardiogram, stethocardiogram, or bal- 
listocardiogram may be shown. Thus, it is possible to 
do much of the teaching of electrocardiography and 
stethocardiography directly from patients without the 
use of slides. The Educational Electron Cardioscope is 
also equipped with a special sound Channel, and each 
seat is wired so that the individual Student, by using 
an electronic stethoscope, may hear the sounds and 
murmurs from the patient's heart as he would through 
his own stethoscope. 

Inasmuch as suitable cases are not always available 
for demonstration, a special tape recorder for heart 
sounds has been developed, and a large library of 
these recordings is available for the demonstration of 
all types of auscultatory phenomenon. 



DISCIPLINE 



In Order to safeguard its ideals of scholarship, char- 
acter, and personal behavior, the University reserves, 
and the Student concedes to the University, the right 
to require the withdrawal of any Student at any time 
for any reason deemed sufficient to it. A prorata return 
of fees will be made if further attendance of any Stu- 



dent is prohibited before the end of a course for which 
such Student has paid his fees. 

The University reserves the right to withhold all 
injormation about the record of any Student who is 
in arrears in the payment of fees or other obligations. 



REGISTRATION 



All students must register in person at the office 
of the dean before attending any course. Payment of 
tuition must be made at the time of registration. 

To make a definite reservation, a deposit may be 
required in advance of the opening date of a course. 
This deposit will not be returned if the applicant fails 



to attend; however, he may attend a course within this 
or the following academic year, and the original 
deposit will be credited. No refund will be made to a 
Student who fails to complete the course in which he 
has enrolled (except in case of serious illness of the 
Student). 



VETERANS 



Veterans who plan to use the educational benefits 
of Public Law 346 must secure from the Veterans 
Administration a Certificate of Eligibility and Entitle- 
ment. Veterans who have previously used benefits at 
another Institution must obtain a Supplemental Cer- 
tificate of Eligibility. In either case, the certificate 
must be presented at the time of registration or the 
Student will be held responsible for the fees. Refunds 
will be made from the effective date of the certificate. 



It is to be noted that the name of New York University, 
the name and dates of the course must appear on the 
certificate. 

Recipients of New York State War Service Scholar- 
ships should present, at the time of registration, evi- 
dence of the award from the New York State Educa- 
tion Department authorizing use of the scholarship at 
New York University. 



63 



mf^ 



General Information 



BOOKS AND SUPPLIES 



In some of the courses, certain books and Instru- 
ments are required; in others, they are merely recom- 
mended. Students are advised to avail themselves of 



the Service offered by the Center bookroom since it 
offers the advantage of lower prices. The bookroom 
is in the Twenty-sixth Street building. 



FOREIGN STUDENTS 



Students from abroad should consult the office of 
the dean concerning admission and course offerings. 
Such applicants must have achieved superior records 
and have sufficient proficiency in English to enable 
them to profit from their educational experience in the 
United States. A written application, including a com- 
plete chronological outline of education abroad, 
together with füll educational credentials in the orig- 



inal and authorized or notarized translations thereof, 
constitutes the first step in the admission process. If 
approved, certificates of admission will be forwarded 
so that the necessary arrangements may be made 
through the office of the American consul. A registra- 
tion fee of $50.00 per academic year is required of a 
foreign Student undertaking recommended postgrad- 
uate work outside of the school. 



STUDENT HEALTH SERVICE 



The physicians of the Student Health Service are 
available for consultation by physicians enrolled in 
the Post-Graduate Medical School who may become 
ill. 

The Student Health Service is located in the ad- 
ministration building of the Post-Graduate Medical 



School at 477 First Avenue. Office hours are from 
12:30 to 1:30 p.m., Mondays through Fridays. Pro- 
vision can be made for caring for emergencies occur- 
ring at other hours by telephoning Oregon 9-3200, 
Extension 389. 



LIBRARY 



The library of the Medical Center, located in the 
Twenty-eighth Street building, is the consolidation of 
the libraries of the College of Medicine and the New 
York Post-Graduate Medical School. 

The library contains Standard textbooks and mono- 
graphs in all fields of medicine, and about 375 differ- 



ent periodicals including foreign ones, are received 
regularly. The library has about 59,000 volumes. 

A reading room is maintained in the Post-Graduate 
Medical School building. This room contains text- 
books and recent periodicals. 



THE TEACHING STAFF 

The list of members of each department was accu- Because appointments were not complete at that time, 
rate at the time this announcement went to press. some of the lists are subject to change. 



'! 



I 

i 



OFFICERS OF ADMINISTRATION OF THE UNIVERSITY 

Henry T. Heald, B.S. in C.E., M.S. in C.E., D. Engr., LL.D., Chancellor 

Harry Woodburn Chase, A.B., A.M., Ph.D., L.H.D., Litt.D., LL.D., Chancellor Emeritus 

Frank Leo Howley, B.S., LL.D., Vice Chancellor for University Development 

LeRoy Elwood Kimball, A.B., A.M., LL.D., Vice Chancellor and Comptroller 

Harold Oliver Voorhis, B.S., A.M., LL.D., Vice Chancellor and Secretary 

*Rufus Daniel Smith, A.B., A.M., LL.D., Provost 

Thomas Clark Pollock, A.B., A.M., Ph.D., Litt.D., Acting Provost 

Elwood Curt Kastner, B.S., LL.D., Registrar; Supervisor of Admissions 

Wesley Raymond Hendershot, B.C.S., Bursar 

Ernest Leopold Hettich, A.B., A.M., Ph.D., Director of the Libraries 

Ralph W. Sockman, A.B., A.M., Ph.D., D.D., S.T.D., L.H.D., Litt.D., LL.D., University Chaplain 

♦On leave of absence to March 1, 1952 



OFFICERS OF ADMINISTRATION OF THE 

MEDICAL CENTER 

Edwin A. Salmon, Director 

Donal Sheehan, M.S., M.B.,Ch.B. [Manchester], M.D., Sc.D., Associate Director 

Currier McEwen, B.S., M.D., Sc.D. (Hon.), Dean, College of Medicine 

Robert Boggs, A.B., M.D.,C.M. [McGill], Dean, Post-Graduate Medical School 

Edwin M. Bernecker, M.D., Hospital Administrator 

Edgar S. Tilton, A.B., Executive Secretary 



64 



65 



-J*V 



INDEX 



Administration, ofücers of : school, 3; University, 65 

Admission, 60, 61 

Anatomy, 6-7 

Anesthesiology, 8 

Application forms, 60, 61 

Audio-visual methods and aids, 63 

Books and supplies, 64 

Calendar of courses, 4-5 

Chemistry, 10 

Degrees: Doctor of Medical Science, 62; Master of 

Science, 62 
Dermatology and syphilology, 11-14 
Discipline, 63 
Foreign students, 64 
Forensic medicine, 15 
General information, 58-64 
Graduate courses, 61, 62 
Gynecology, 29-3 1 

Hospitals affiliated with the Medical Center, 2, 58 
Industrial medicine, 16-17 
Library, 64 
Medicine, 18-26 
Microbiology, 27 
Neurology, 48-50 
Neurosurgery, 28 



New York University— Bellevue Medical Center, 58 

Obstetrics and Gynecology, 29-31 

Ophthalmology, 32-34 

Orthopedic surgery, 35 

Otorhinolaryngology, 36-38 

Pathology, 39 

Pediatrics, 40-42 

Pharmacology, 43 

Physical medicine and rehabilitation, 44-45 

Physiology, 46 

Post-Graduate Medical School, 58 

Postgraduate courses, 60 

Preventive medicine, 47 

Professors emeriti, 3 

Psychiatry and neurology, 48-50 

Radiology, 52-53 

Regional Hospital plan, 59 

Registration, 63 

Rehabilitation, 44-45 

Student health service, 64 

Surgery, 54-56 

Syphilology, 11-14 

Urology, 57 

Veterans, 63 



■,i 



i 



66 



Fortschritte / Advances / Progrfes 

Antibiotica et Chemotherapia. Fortschritte / Advances / Progr^s. Hgb. 
von / edited by / dirig6 par H. Bloch, O. Gsell und E. Langer. 
Vol. 1:X + 378 p., 113 flg., 1 färb. Taf., 1954. . . . sFr. 52.— 

Fortschritte der Augenheilkunde / Advances in Ophthalmology / Progre« 

en Ophthalmology. Hgb. von / edited by / dirig6 par E. B. Streiff. 
Vol. 1: Xfl + 291 p., 1952. (Bibl. Ophthal, fasc. 36.) . . sFr. 39.50 
Vol. 2; VIII + 333 p., 28 fig., 1953. (Bibl. Ophthal, fasc. 38.) sFr. 39.50 
Vol. 3: VIII 4- 336 p., 1954. (Bibl. Ophthal, fasc. 39.) . sFr. 39.50 
Vol. 4: ca. 350 p., ca. 50 fig., 1954. In Vorbereitung 

Fortschritte der Biochemie 1938-1947. 

Von F. Haurowitz. VIII + 364 p., 5 fig., 1948 . . . sFr. 41.60 

Fortschritte der Geburtshilfe und Gynäkologie. 

Vol. 1 : Mit Beiträgen v. W. Neuweiler, P. Jung u. O. Käser. 

88 p., 4 fig., 1950. (Bibliotheca Gynaecologica fasc. 9). . sFr. 9.35 

Vol. 2: Mit Beiträgen von A. Reist und H. Hosemann. 149 p., 

25 fig., 1951. (Bibliotheca Gynaecologica fasc. 10.) . . sFr. 18.70 

Fortschritte der Hals- Nasen- und Ohrenheilkunde / Advances in Oto- 
Rhino-Laryngologie / Progres en Oto-Rhino-Laryngologie. 
Hgb. von / edited by / dirige par L. Rüedi. 
Vol. 1: Mit Beiträgen von M.Arslan, L. B. W. Jongkees 
und E. Wodak. VIII + 263 p., 49 fig., 1953. (Bibliotheca 

Oto-Rhino-Laryngologica fasc. 1.) sFr. 36. — 

Vol. 2: Mit Beiträgen v. F. Altmann u. K. Graf. VH-274 p., 

40 fig., 1955 sFr. 36.— 

Fortschritte der Tuberkuloseforschung / Advances in Tuberculosis 
Research / Progres de TExploration de la Tuberculose. 

Hgb. von / edited by / dirig6 par H. Birkhäuser und H. Bloch. 
Vol. 1/2: IV+446 p., 5 fig., 1948. (Bibl. Tuberc. fasc. 1-2.) sFr. 52.— 
Vol. 3: IV + 307 p., 13 fig., 1950. (Bibl. Tubcrc. fasc. 3.) . sFr. 39.50 
Vol. 4: 308 p., 59 fig., 1951. (Bibl. Tuberc. fasc. 5.) . . sFr. 43.70 
Vol. 5: VIII + 370 p., 79 fig.,. 1952. (Bibl. Tuberc. fasc. 6.) sFr. 46.80 
Vol. 6: ca. 250 p., ca. 120 fig., 1954. (Bibl. Tuberc. fasc. 9.) sFr. 32.— 

Progress in AUergy / Fortschritte der Allergielehre. 

Edited by / hgb. von P. Kallös. 

Fo/. /; 400 p., 38 fig., 1939 VergrifTen 

Vol. 2: VIII + 356 p., 50 fig., 37 tab., 1949 .... sFr. 37.45 

Vol. 3: VIII + 572 p., 82 fig., 61 tab., 1 col. plate, 1952 . sFr. 68.65 

Vol. 4: VIII + 520 p., 149 fig., 63 tab., 1954 .... sFr. 68.65 

Wiederherstellungschirurgie und Traumatologie / Reconstruction Sur- 
gery and Traumatology / Chirurgie Reparatrice et Traumatologie. 

Jahrbuch / Annual Survey / Annuaire. Hgb. von / edited by / dirig6 
par M. Lange. 

Fo/./: VIII + 260 p., 101 fig., 1953 sFr. 36.— 

Fo/. 2: IV + 244 p., 129 fig., 1954 sFr. 36.— 



BASEL (Schweiz) 



S. KARGER 



NEW YORK 



Proceedings 
of the 

Rudolf Virchow 
Medical Society 

in the City of New York 



Volume XII 
1953 

Edited by the Rjblication Committee 
Hans Behrendt / Joseph Berberigh 

HAR KaLIND^SKY 



\ 




BASLE (Switzcrland) S. KARGER Publishcrs NEW YORK 




Antibiotica et Chemotherapia 

Fortschritte / Advances / Progres 

Herausgegeben von — edited by — dirig6 par 

H. BLOCH O. GSELL E. LANGER 

New York Basel Berlin 

VOL. 1 

X + 378 p., 113 fig., 1954. sFr. 52.— 

INDEX 

Die neuere Entwicklung der Antibiotica als Arzneimittel. 
Von J. BÜCHI, Zürich. 

Die Behandlung der Endocarditis lenta mit Antibiotica. 
Von H. BARTELHEIMER und W. ENGERT, Berlin. 
Sulfonamide Combinations. 
By S. HELANDER, Stockholm. 

Les accidents provoqu^s par les Antibiotiques. 
Par P. RENTCHNICK, Gen^ve. 

Antibiotica und Pilrerkrankungen der Haut und Schleimhaut. 
Von H. GRIMMER, Berlin. 

Pilzerkrankungen der inneren Organe als Folge von Behandlung 

mit Antibiotica, unter besonderer Berücksichtigung des 

Respirationstraktes. Von T. WEGMANN, Zürich. 

Wirkung der Antibiotica, insbesondere des Penicillin, auf das 

vegetative Nervensystem und das Endocrinum. 

Von W. BLAICH, Münster. 

Antibiotica in der Pädiatrie. Von E. ROSSI, Zürich. 



Medizinische Monatsschrift, Heft 9, 1954: «Die Absicht der Heraus- 
geber des vorliegenden Werkes, eine in Form eines Jahrbuches in 
Slf. '^'n ^'n? -jfderkehrende Übersicht über den Stand der 
antibaktenellen Behandlung zu schafTen, wird nicht nur von den 
Kennern des Fachgebietes, die ja selbst vor einer kaum zu bewältigen- 
den Literaturanhaufung stehen, sondern vor allem von den Ärzten 
die am Krankenbett stehen und täglich zu antibiotischen Mitteln grei- 
fen müssen, ehrhch begrüßt werden. Schon der erste hier vorliegende 
Band bringt eine Anzahl vielversprechender Einzeldarstellungen aus 
der Feder hervorragender Sachkenner.» 



BASEL (Schweiz) 



S. KARGER 



NEW YORK 



\ 



s 



's 
l 



Proceedings 
of the 

Redolf Virchoiv 
Medical Society 

in the City of New York 



Volume XII 
1953 

Edited by the Publication Committee 

Hans Behrendt Joseph Berberich 

Lothar Kalinowsky 




BASLE (Switzerland) S. KARGER Publishers NEW YORK 



All rights, including that of translation into foreign languages, reserved. 
Photomechanic reproduction (photocopy, microcopy) of this book or part of it without special permission 

of the publishers is prohibited. 

Copyright 1954 by S. Karger A. G., Basel. 

Printed in Switzerland by Buchdruckerei Zur Neuen Aargauer Zeitung, Aarau. 



CONTENTS 



MEETING OF JANUARY 5th 

Aesthetic Considerations in Reconstructive Plastic Surgery 
Gustave Aufricht 

Treatment of Hypertension with Ganglionic Blocking Agents 
Paul H. Kuhn 



Discussion: Emil Glass 



1 

2 

13 



MEETING OF FEBRUARY 2nd 

Insecticides 15 

Ludwig Teleky 

Lead Poisoning in Children 21 

Frederick G. Zak 

Ambulatory Anticoagulant Therapy. An Evaluation of a 4 Years 
Experience (Manuscript not received) 
Kurt Lange 

MEETING OF MARCH 2nd 

Selected Legal Topics 22 

Albert Hirst 

Psychiatric Aspects of Criminal Behavior 35 

Leo L. Orenstein 

MEETING OF APRIL 6th 

Symposium on Ulcerative Colitis 

Medical Aspects 37 

Charles L Krieger 

Surgical Aspects 45 

Helmuth Nathan 



III 



J 



Psychiatric Aspects ^^ 

Bernhard C. Meyer (by invitation) 

Pathologie Aspects (Manuscript not received) 
Max Wachstein 

MEETING OF MAY 4th 

Demonstrations: 

Newer Techniques in Cineplastic Amputations 52 

Ernst W. Bergmann 

Pulmonary Sarcoidosis 54 

F. C. Burgheim 
Acute Mesenteric Vascular Occlusion Following Mumps ... 56 

Wolf Elkan 
Craniopharyngeomas in Children and Adults and their Operative 
Treatment by the Transphenoidal Method 
(Manuscript not received) 

Oscar Hirsch (by invitation) 

Treatment of Excessive Smoking by Hypnosis 60 

Edith Klemperer 

Cancer of the Lungs and Lobectorny 62 

Richard Lewin 

Myocardial Infarction in a 24 Year old Boy 66 

Rudolf A. Stern 

Bovine Tuberculosis of the Kidney 69 

Alfred Zinner 

MEETING OF OCTOBER 5th 

Supervoltage Roentgen Therapy 73 

F. C. Burgheim 

The Physical Aspects of Radioactive Cobalt Therapy . ... 11 
Lillian E. Jacobson (by invitation) 

The Diagnostic and Therapeutic Uses of Radioactive lodine . . 89 
Martin Perlmutter (by invitation) 

MEETING OF November 2nd 

The KimmelstieUWilson Syndrome and its Clinical Variants . . 91 
Harold Rifkin (by invitation) 

Medical Management of Peripheral Vascular Diseases in Diabetes 95 
Heinz I. Lippmann 



IV 



Surgical Management of Peripheral Vascular Diseases 
Samuel Silbert (by invitation) 

Ocular Manifestations in Protracted Diabetes 

Georges Kleefeld (by invitation) 

Insulin Management of Diabetes 

Martin G. Goldner 

MEETING OF DECEMBER 7th 

Superfical Ulceration of the Urethral Meatus in Male Children 
Paul Freud 

Some Non-Tuberculous Chest Diseases in Children 
Helene Eliasberg 

Apocrine Sweat Glands and Sexual Development 
H. Behrendt 

Discussion: H. Vollmer 



103 
104 
107 



Obituaries 

Presidents of the Rudolf Virchow Medical Society 
Members of the Rudolf Virchow Medical Society 



113 
115 
121 
121 

124 
127 
128 



AESTHETIC CONSIDERATIONS 
IN RECONSTRUCTIVE PLASTIC SURGERY 

Gustave Aufright 

The plastic surgeon deals with the reconstruction and repair of 
defects and deformities mostly on the surface of the body. The defects 
may be acquired by trauma, such as war injuries, automobile acci- 
dents, bums, etc., or caused by pathologic conditions, such as neo- 
plasm, or infectious diseases (lues, tuberculosis, etc.) or they may be 
congenital such as hare lip, congenital absence of ear, syndactylia, 
extensive nevi, etc. The condition actually is a surgical problem and 
the reason for the plastic surgeon's interest and aptitude to deal with 
these reconstructions is not only his experience with transplantation 
for replacing tissue losses but his special training and attention to the 
aesthetic details and accuracy. From the plastic surgeon's i>oint of 
view it is not sufficient to close the defect or cover it with a skin graft 
or Aap. The reconstructed part has to be re-built to normal contours 
and the transplant should be as good a match as possible to the 
original, in thickness, texture, color, hairiness, etc. The scars with the 
neighboring region should be placed as inconspicuously as possible. 
Attention must be paid also not to cause unsightly secondary dis- 
figurement at the place of the donor site. The plastic surgeon always 
keej>s before his eyes the aesthetic requisites of reconstruction. 

( Illustrated with slides and film. ) 



1« 



TREATMENT OF HYPERTENSION WITH 
GANGLIONIC BLOCKING AGENTS 

Paul H. Kuhn 

A physician who is called upon to treat a hypertensive patient 
would do well to be guided by the foUowing known facts which have 
emerged from the wealth of clinical experience and experimental work 
in the field of hypertension. 

1 ) Many cases of essential hypertension follow a benign course. 

2) The etiology of essential hypertension is not yet clearly under- 
stood. There are probably several factors, neurogenic, humoral, 
endocrine, infectious, etc., which in combination lead to the 
development of what is known as essential hypertension. The 
clinical features of this entity do not disclose in which proportion 
these factors bear upon the etiology of the disease. 

3 ) The height of the diastolic blood pressure is directly related to the 
amount of resistance encountered by the blood flow within the 
narrowed lumina of the smaller arteries and arterioles. 

4) The prognosis dep>ends upon the elevation of the patient's dia- 
stolic blood pressure. 

The logical deductions from these facts are as foUows: There is 
no etiological treatment of this disease. The patients do well for many 
years on a conservative regime, such as physical and mental rest, 
reassurance by the physician, moderation in their living habits, and 
mild sedation. Only a small percentage of patients show either disturb- 
ing subjective Symptoms or alarming objective findings that are suf- 
ficiently serious to Warrant drastic therapeutic measures; and even 
in those cases, the physician should give his patients the benefit of a 



prolonged rest and thorough clinical Observation before rushing them 
into a theraj>eutic adventure, which, like surgical intervention, is 
irreversible and which, like drug treatment, may be hazardous. 

Contemplation of more drastic therapeutic measures at once 
raises the question as to which hypertensive patients should be sub- 
jected to more aggressive methods of treatment and which method is 
the most desirable for the individual case. 

Pickering ( 1 ) and others have shown that a patient with a per- 
manently elevated diastolic blood pressure above 140 mm. Hg is in the 
danger zone and the benign course of his disease may, at any time, 
change into the malignant phase. Hemiplegie death occurs twice as 
often in the group with pressure above 200/120 as in that with pres- 
sure of 180/110 (Beckman, 2). There are patients with disturbing 
and, at times, disabling manifestations of intractable headaches, diz- 
ziness, vertigo, breathlessness, repeated epistaxis, recurrent pulmonary 
edema and serious visual disturbances caused by rapidly deteriorating 
fundus changes exceeding Grade 2 of Keith's and Wagener's Classifi- 
cation. Last, but not least, there are the toxemias of pregnancy, which, 
at times, can be classified as hypertensive emergencies. All these 
patients need sj>ecial consideration. 

True, some of these cases at times have reacted favorably to 
sodium restriction in their diet and/or to sodium and protein restriction 
(rice diet Kempner). However, in time, these strict and unpalatable 
diets become so monotonous that the patients resent them and finally 
refuse to continue with the dietary regime, even though they are con- 
vinced of its value. 

Surgical sympathectomy has been of benefit to some patients 
whereas others have had relapses of their hypertensive disease after an 
Operation, and some have not reacted at all to surgical intervention. 
Unfortunately, there is no method known to insure that only those 
patients will be operated upon who will respond to operative treat- 
ment. 

E. V. Allen (3) writcs: "It is, therefore, logical to believe that, if 
the problem of essential hypertension is solved, it will be solved by 
medical measures." If the blocking of the transmission of nervous Im- 
pulses decreases the tonus of the smaller blood vessels and lowers the 



Table 1 

Criteria for Effectiveness of Hypotensive Drugs 

(Edward D. Preis, Medical Clinics of America, 32, 5. Sept. 1948) 

1 ) Agent should lower blood pressure significantly in a fair proportion of patients. 

2) Hypotensive eflFect should be accomplished without serious detriment to the 

patient. 

3) Hypotensive response should be accompanied by clinical indication of arrest or 
preferably reversal of the disease (symptomatic relief, reduction in cardiac 
size, Clearing of neuroretinitis, etc.). 

4) Drug should have a duration action of at least 8 hours. 

5) Satisfactory drug should be efFective by mouth or at least subcutaneous in- 
jection. 



resistance to the blood flow, the blood pressure logically will fall, and 
secondary organic changes, like retinitis, cardiac hypertrophy, etc., 
will disappear. TJiis has been proved to be the case after surgical 
sympathectomy and there is no reason to assume that "chemical sym- 
pathectomy" cannot do the same thing. In the last few years, old drugs 
have been re-examined for their pressure-reducing qualities and new 
drugs have been designed for this purpose. The drugs now at our 
disposal can be conveniently divided as follows: 

1 ) Drugs whose action is not due to any reversal of vascular changes. 

2) Drugs whose primary action is upon the sympathetic and para- 
sympathetic nervous System (adrenergic and sympatholytic drugs). 

3) Drugs which interrupt the transmission of nervous impulses from 
the central nervous System to the periphery at the level of the 
ganglionic Synapse (ganglionic blocking drugs). 

The selection of the most suitable drug for the individual patient 
has already become a serious problem due to the list of "efTective" 
drugs provided by the busy pharmaceutical industries. A few basic 
principles of drug treatment, first formulated by Freis (4), will help to 
make a selection (Table 1 , 2, 3 ) . Points 4 and 5 of Table 3 need partic- 
ular emphasis. A duration of drug action of about 8 hours is important 
either to minimize the danger of infection from too frequent injections, 
or its interference with digestion and proper resorption of the drug by 
oral administration. Effectiveness by mouth, or at least by subcutan- 
eous injection, which the patient can be trained to give himself, makes 



Table 2 
Indications for the Use of Hexamethonium in Hypertensives 

1) Persistent elevation of the diastolic blood pressure above 140 mm. Hg whilc 
patient is at complete rest and thoroughly relaxed and after conservativc 
measures, such as bed rest, sedation, sodium restriction, rice diet and psycho- 
therapy have been proven unsuccessful. 

2) Severe and disturbing clinical manifestations, such as intractable headaches, 
dizziness, vertigo, breathlessness, pulmonary edema, repeated epistaxis and 
serious visual disturbanccs caused by rapidly deteriorating fundus findings 
exceeding Grade 2 of Keith's and Wagener's Classification. 

3) Toxemia in pregnancy and eclampsia. 

Contraindications for the Use of Hexamethonium in Hypertensives 

1) Impaired renal function (azotemia). 

2) Recent blood losses. 

3) Advanced coronary artery disease and cerebral thrombosis. 

4) Persistent constipation, not yielding to proper management. 

Table 3 
Action of Hexamethonium Chloride 

1 ) Inhibits or blocks the transmission of nervous impulses through the sympathetic 
and parasympathetic ganglia. 

2) Produces reduction of blood pressure in hypertensive patients by removal of 
the abnormal vasoconstrictor tone. Effect obtained varies considerably, cor- 
responding to the relative proportions of neurogenic and humoral components 
of the raised blood pressure. 

3) Reduces bleeding during surgical Operations by reducing or abolishing sym- 
pathetic tone and pooling of blood in the vessels of a dependent part of the 
body. 

4) Depresses the volume and acidity of the gastric secretion and motality. 

5) Causes dilatation of the pupils and dryness of the mouth (atropine-like cffect). 



the procedure itself independent of the physician's personal attendance, 
and contributes to the willingness of the patient to cooperate. 

Our own experience has been restricted to the administration of 
one of the ganglionic blocking agents, the hexamethonium chloride 
(Methium). This should not be construed as a discrimination of other 
drugs. After searching the literature on these preparations and after 
having had a few preliminary experiences of our own with some of 
these drugs, Methium seemed the most suitable drug for our purpose, 
and, despite certain undisputed disadvantages, the most promising 
one for a prolonged treatment of essential hypertension. This drug did 



Table 4 
Toxic Reactions of Hexamethonium 

All toxic reactions can be traced to the blocking action of Hexamethonium 
upon the autonomous nervous System: 

1 ) Postural hypotension — > faintness -> vertigo -» syncope 

2) Atonia of the guts, causing constipation and a condition resembling paralytic 
ileus 

3) Nausea, vomiting, diarrhea 

4) Blurred vision, dryness of the mouth 

5) Paralysis of the bladder with urinary retention. 

6) Decrease in libido. 



not seem too hazardous, provided a rather strict routine was followed 
during its administration, the details of which will be discussed. The 
convenient oral route of application is especially controversial and 
needs further study. 

The Hexamethoniums, one of which is Methium (Hexamethon- 
ium Chloride), are powerful hypotensive drugs, effective by the par- 
enteral, as well as the oral route. One of their so-called disadvantages 
is the poor, irregulär and erratic absorption from the intestinal tract. 
When the urinary excretion is used as an index of the amount of the 
dose absorbed, absorption ranges from 5-10 %. This index corres- 
ponds with the clinical Observation that roughly ten times more of the 
drug must be given by mouth to obtain the same efifect as with par- 
enteral dosage ( Paton and Zaimis, 5 ) . For this reason, as well as the 
risk created by the irregulär absorption of the drug, the oral admin- 
istration has been termed unsatisfactory by many observers (Graham 
and Campbell, 6; M. L. Rosenheim, 7, and others). We disagree on 
the basis of our experience. The so-called poor absorption rate is an 
advantage, rather than a disadvantage, of the drug, provided a regulär 
absorption of the 5-10 % from the intestinal tract can be achieved 
with a strict and proper regime. With the absorption rate regulated, 
the "poor" absorption prevents, rather than creates, overdosage and 
toxic side eflfects. It should be kept in mind that the action of Hexa- 
methonium is considerably enhanced by a salt poor diet, and a smaller 
dosage of the drug can be given to patients following this dietary 
regime, which also tends to minimize the toxic side efTects and has 
become an integral part of our therapeutic measures. 



Table 3 gives a clear outline of the action of Methium, and 
Table 4 explains its possible toxic reactions which can be traced to 
ganghonic blocking action. Blurred vision and dryness of the mouth 
are the usual side efTects of the drug and, as a rule, are not particularly 
bothersome. Decrease of libido has been observed more in the male 
than in the female patient, catching the patient by surprise, but is of 
no significance as it is a transitory Symptom, disappearing immediately 
with the cessation of the medication. Postural hypotension is a desir- 
able effect of the drug, rather than a toxic side efTect. Atonia of the 
guts, together with its result constipation and paralytic ileus, seem to 
be features which can be avoided, and paralysis of the bladder has 
fortunately never occurred in our series. 

Before reporting our own results, it may prove of value to discuss 
briefly the contraindications to the use of Methium in hypertensive 
patients. Hexamethonium is excreted as an unchanged compwDund 
solely by the kidneys and it is therefore only logical to postulate that 
the kidney function should be intact, or at least not damaged, to an 
extent as to interfere with the elimination of the drug from the blood. 
An undue increase of the blood level will naturally create the danger of 
toxic reactions. Elevated blood levels may also be due to a stepped-up 
resorption from the intestinal tract in cases of constipation, when the 
drug remains in the guts for too long a period of time. Therefore, the 
digestive functions of the patient need special attention, and chroni- 
cally constipated patients not responding to proper management in 
their pre-treatment period are better excluded from the oral admin- 
istration of Methium, as furthermore the drug lowers the blood pres- 
sure and slows down the blood flow. This increases the danger of 
thrombosis and, in cases of advanced coronary or cerebral thrombosis, 
or recent and extensive blood losses, makes the use of Hexamethonium 
inadvisable. 

We have thus far employed Methium in 22 selected cases. The 
first patient began to take the drug in April, 1952, which makes the 
Observation period rather short and the number of cases studied not 
large enough to give a fair Impression as to the effectiveness, or failure, 
of the drug. This report is, therefore, a preliminary one. Its findings 
are of necessity highly subjective and its deductions may prove to be 



premature and in need of correction in many of its ramifications. There 
is one point, however, which should be stressed in view of a few recent 
very antagonistic reports: Due to the fact that we were extremely care- 
ful in the selection of our cases and followed a very strict routine, we 
did not run into any serious trouble, discontinuing the treatment in 
several cases, where we were not certain that the routine we prescribed 
was followed by the patient in its minute detail. The foUowing case 
reports will illustrate certain points of our hypothesis: 

F. S., a 42 year old male clerk, was first seen at the office on April 21, 1952. 
For many years he had been suffering from "migraine headaches", which had 
disappeared spontaneously. In December, 1951, he feit light headed and, at times, 
dizzy, and visited his physician for a general examination. He was told that his 
blood pressure was considerably elevated and that he should take things easy and 
stop Smoking 80 cigarettes a day. There was a family history of hypertension and 
both parents died from cerebral accidents at the age of 62 and 52 respectively. 
On April 20, 1952, he sufFered a sudden severe epistaxis, which lasted for several 
hours and was stopped by tamponade of the nose. He was told by the attending 
physician that his blood pressure needed immediate treatment. The patient was 
66/2 inches tall and weighed (stripped) 175 Ibs. The face was flushed and a 
slight dyspnea on exertion, as well as orthopnea, were present. Fundi showed 
Grade H hypertensive changcs but no blurring of the discs. The enlargement of 
the heart was very marked and extended to the lef t anterior axillary line ; a systolic 
murmur was audible over the entire precordium, His blood pressure was 240/160. 
The EGG showed a sinus tachycardia and marked left ventricular strain. The 
urine had a specific gravity of 1.018 and did not contain any albumin, sugar or 
urobihnogen. He was hospitalized and his basic blood pressure was established at 
230/140. Further course and medication are shown in Fig. 1. His blood pressure 
slowly receded and the patient feit well and was discharged from the hospital on 
May 12, 1952, with a blood pressure of 140/95 and a weight loss of 10 Ibs. His 
maintenance dose at that time was 2 grams a day, divided into 4 doses of 500 mg. 
each. He has continued this dosage ever since, with no toxic side effects what- 
soever, and has not lost a single day of work. His blood pressure now ranges 
between 160-170 over 100-110. He has had no recurrence of his epistaxis. X-ray 
examination on December 20^^ showed marked reduction of the size of his heart. 
The EGG revealed a slurring of his heart rate, a lowering of the voltage, and a 
diminution of the left ventricular strain. There were no changes in the condition 
of the fundi. 

E. B., a 57 year old housewife, was seen first in consultation on June 16, 
1952. She was a known hypertensive for the past 10 years and had several mild 
cerebral vascular accidents. She complained of severe headaches, extreme general 
weakness, dizzy spells, shaking of the right hand (which interfered with writing 
and needlework) nycturia, and dyspnea on exertion. Her last cerebral accident a 
few weeks prior to the examination was coupled with vertigo. She collapsed early 
in the moming in the bathroom and Struck her head against the wash basin, 
suffering several lacerations of the scalp which required hospital treatment. She 



8 



had been digitalized for several years and receivcd Veratrite while in the hospital 
but without much relief. There also was a family history of hypertension. Both 
parents and one sister died from cerebral accident and coronary occlusion respec- 
tively. She was 64/2 inches tall and weighed (stripped) 157 pounds. She had a 
slightly flushed face and mild cyanosis of the lips, but no dyspnea or orthopnea. 
There were minor varicosities of both legs but no pretibial edema. The heart was 
not enlarged, the heart sounds were distant and poor, and the second aortic sound 
was accentuated. A systolic murmur could be heard over the aortic area. The 
blood pressure was 190/110 and the EGG showed left axis deviation and left 
ventricular strain. There was slight posturing of the pronated forearm and fist- 
making was not as facile with the right as with the left hand. On Walking there 
was a tendency towards diminished automatic swinging of the right arm, and a 
fine tremor of the right hand was present. The face was slightly set and the left 
Corner of the mouth was somewhat lower than the right. Fundi showed AV 
nicking but no blurring of the discs. Urine analysis revealed a specific gravity of 
1.010, no albumin, sugar or urobilinogen. Blood count and Sedimentation rate 
were normal. PSP showed a total elimination of 63 % of the dye, and the highest 
concentration of the urine was only 1.015. A diagnosis of essential hypertension 
and hypertensive encephalopathy was made and the patient was hospitalized. 
Under bed rest, salt-poor diet, and sedation, her systolic blood pressure receded 
to 170, but the diastolic remained unchanged and her complaints continued. On 
June 19, 1952, she was put on 500 mg. of Methium and the blood pressure 
promptly dropped. On June 27^^^ a slight rise was again noticed and the dose of 
Methium was increased to 750 mg. On June 28**^, her Standing blood pressure 
had fallen to 130/80, she had no headaches any more and asked to be discharged 
in the care of her local physician. When I saw the patient again on July 10*^^ she 
had been kept on a maintenance dose of 750 mg. of Methium and her blood 
pressure was 150/90. Her general condition was very satisfactory. There was no 
headache, no dizziness, the weakness had disappeared and the shaking of her hand 
was no longer noticeable. She claimcd that she was able to write and crochet 
again and that she had no more dyspnea. Her maintenance dose was again in- 
creased to 825 mg. of Methium daily and she was again seen on August 27^, 
when all subjective Symptoms had practically disappeared and her blood pressure 
was 120/70. Ever since she is continuing her maintenance dose, her blood pressure 
does not change and she is feeling well. 

E. G., a 62 year oid hospital administrator, was first examined on May 21, 
1952. His hypertension was discovered quite accidentally 5 years ago, when he 
applied for a life insurance poiicy. In September, 1950, he had a mild cerebral 
accident while riding in a subway and had to be hospitalized. He was treated 
with bed rest, diet, sedation and injections of an unknown drug. He did not 
improve and complained of dizziness, grogginess, fatigue, tremor of both hands, 
constant "funny feeling*' in the head, and palpitations. He had stopped smoking 
5 years ago on the advice of his physician and lives a very quiet life. 

He was 65 inches tall and weighed (stripped) 135 Ibs. He had a rigidity 
of facial expression and a very slow gait. There was edema of both legs and a 
rather coarse tremor of both hands. The fundi showed blurring of both discs, in- 
creased arteriolar reflexes and AV nicking, but no old or fresh hemorrhages. The 
heart was not enlarged, but the second aortic sound was accentuated and a rather 



harsh systolic murmur could be heard over the entire precordium. Blood pressure 
was 195/100 The urine concentrated to 1.023 and showed a faint trace of albu- 
min. PSP showed a 60 % excretion in the first hour, and the Urea Nitrogen was 
14 3 mg.% Blood count and Sedimentation rate were normal. 

As this patient was a hospital administrator, he was not hospitalized but 
was Seen daily at the hospital. From May 21^t until July lOth, he was kept on a 
salt-poor diet, vitamins and sedation. His blood pressure went up to 210/1 lU and 
his condition remained unchanged. Following the administration of 500 mgs of 
Methium in four divided doses, his blood pressure came down to 180/90. When 
we increased the dose to 750 mg., he first feit rather well, but on August ^t, he 
complained of weakness and a feeling of faintness, as well as a slight nausea, 
dryness in the mouth, and blurred vision. His blood pressure was 120/70. It was 
assumed that his maintenance dose was probably too high and it was agam reduced 
to 500 mg. in four divided doses. On August 8th, there were no subjective com- 
plaints and the blood pressure had risen to 140/98 and he feit very well. On 
August 19th, his blood pressure was 132/94 and on September 2nd, it was 140/98. 
The patient spontaneously claimed that he had not feit as well in many years, he 
went to work every day despite the unusual summer heat. On October 15th, he 
complained of nervousness, palpitations, and giddiness, his blood pressure was 
170/98, and his physical findings were satisfactory. He claimed that he was 
nervous because his sistcr-in-law had been attacked and robbed in the apartment 
house in which he and his wife were living, that he was in constant fear it could 
happen again, and could happen to him. Ever since, his systolic pressure has been 
higher, but the diastolic pressure remains at a level slightly below 100 mm. Hg. 

J. H., a 65 year old French seamstress and war bride of World War I, was 
known to me since June, 1940, when she visited my oflfice with complaints of 
occipital headaches, dizziness, insomnia and a choking Sensation in her head. She 
had always been emotionally unstable. Her weight at that time was 145 Ibs., and 
her blood pressure 170/90. In the 12 years I have observed the patient, her 
weight increased to 157 Ibs., and the blood pressure to 260/140. She had a mild 
coronary occlusion in March, 1948, which left her with a moderate myocardial 
damage causing occasional premature beats, which, at times, became the source 
of highly emotional complaints. Her heart became enlarged in 1948 and a harsh 
systolic aortic murmur developed that was audible over the entire precordium. 
In September, 1951, she had a cerebral accident which, after a few days of a 
complete right-sided hemiparalysis, left her with a certain spasticity and weakness 
of that side of the body. Her blood pressure remained elevated (250/140) and 
she complained bitterly of dizziness, severe headaches, and blurring of her vision. 
The slightest effort, as climbing one short flight of stairs up to her room in the 
slums, left her shortwinded and exhausted for a long period of time. She always 
lived very irregularly, smoked excessively and ate poorly balanced meals. In the 
hope of getting some relief from her distressing Symptoms, she agreed to cooperate 
in this new treatment. I should have known that a person accustomed to such an 
irregulär mode of life would be uncooperative. She was briefed and put on 500 mg. 
of Methium on July 27, 1952. The initial response was favorable. By August 12^^, 
her blood pressure had fallen to 180/110. She feit considerably better, her head- 
aches had disappeared, she could walk better and climb the flight of stairs to 
her room without difficulties. However, she resented the strict diet, the laxatives, 

10 



and many of the rules and regulations. When the dose of Methium was increased 
to 625 mg. on August 20*^, her blood pressure feil to 160/104 and the patient 
feit lightheaded, faint, and complained of palpitations. When the dose was 
reduced to 500 mg. the blood pressure went up and the readings became irregulär. 
She conceded that she did not adhere to the regimen "too" strictly, and we thought 
it better to take her off the drug before dangerous reaction would occur. 

In the foregoing discussion, we have stressed repeatedly the point 
that success or fall uro of treatment with ganghonic blcx:king drugs 
may very well be determined by the way in which cases are selected 
for this kind of therapy. Indication and contraindication for the use 
of hexamethonine in the individual patient can best be established by 
hospital Observation. We are not satisfied - as many physicians are - 
with data obtained during ambulatory examinations. Each patient 
should be hospitalized for diagnostic work-up, proper briefing, and 
Observation of the initial response to therapy. 

Basic blood pressure must be established by instituting bed rest, 
salt-poor diet and sedation. Kidney function is ascertained by clearance 
and excretion tests, and the condition of the myocardium is properly 
evaluated. 

Special attention should be paid to the regulating of bowel func- 
tion. Mild saline laxatives should be administered routinely. 

Patients whose constipation cannot be overcome are better re- 
jected as poor risks. Among other things, the hospitalization period 
gives the patient an opportunity to receive some valuable hints from 
the dietitian in regard to the salt-poor diet which is an integral part 
of the entire therapeutic regimen. 

Proper Instruction and briefing of the patient is part of initia- 
ting the treatment. He has to be told in detail, what he has to expect, 
what the "normal" reactions to the drug may be, and how he can 
minimize or overcome them. The toxic reactions should be explained 
to him and he should be informed that he must contact his physician 
promptly each time he has a new reaction. Under no circumstances 
should he ever increase, decrease, or stop his medication without in- 
forming the physician as particularly severe kidney reactions have 
been observed after sudden withdrawal of the drug. 

The so-called postural hypotension, meaning the drop of blood 
pressure in a Standing position, is a desired effect of the ganglionic- 

11 



2 Virchow Society, Vol. 12 (1953) 



blocking drugs and not a manifestation of toxicity. It is the most 
sensitive indicator of proper dosage. 

When the Standing blood pressure is charted graphically, the 
development of tolcrance or toxicity becomes evident immediately. 
In the latter case, the curve drops abruptly even before clinical Sym- 
ptoms appear, and in the former case, it increases slowly. The drop 
calls for an immediate reduction of the dose, and the rise for its in- 
crease. A dosage schedule, based on the evaluation of the Standing 
blood pressure, safeguards the regulation of the drug therapy. It is 
inadvisable to foUow rigid dose schedules as each and every case 
requires individual handling. It is always well to remember that 
hypertension is an adaptation Syndrome, and that the body has made 
its adjustment to the altered physiological State of the vascular System 
over a period of many years. Therefore, it should, and will, take time 
for the body to re-adjust itself to lower blood pressure levels. For this 
reason, and in order to avoid serious side effects, the blood pressure 
should be reduced slowly over a period of many weeks. Relief from 
distressing Symptoms, and the slow improvement with the disap- 
pearance of physical signs, are more impK)rtant than the establishment 
of ideal blood pressure values. The smallest dose which can keep the 
blood pressure on an even level should be accepted as a maintenance 
dose. 

The administration schedule of the drug also needs careful 
watching. The drug should be given on a fasting stomach at least 
4 hours after the previous meal, and about 1 hour before the follow- 
ing meal, in order to obtain better resorption from the intestinal tract. 
As poor and irregulär absorption is one of the pitfalls of oral adminis- 
tration, optimal conditions for the resorption of the drug should always 
be established. Also sudden discontinuation of the agent should be 
avoided, as cases have been repoited in which a sudden withdrawal 
has caused serious kidney disturbances. 

In case of serious complications, such as vertigo, giddiness, severe 
constipation, paralytic ileus, or retention of urine, the dose should 
be reduced immediately and antidotes be given at once: UrochoHn 
and Neostigmin in paralytic ileus and urinary retention, and Neo- 
synephrin in severe hypotensive states. 

12 



Our ex{>erience with oral medication of a ganglionic blocking 
agent (Methium) in 22 consecutive cases of essential hypertension 
can be summarized as foUows: 

The ganglionic blocking agents are powerful drugs, and their 
employment in hypertension has many pitfalls. However, with proper 
selection of cases and proper regard to technical requirements good 
clinical results can be obtained at not too great a risk. 

The drug therapy in essential hypertension is in its infancy; 
better and less toxic agents will doubtlessly be available in the near 
future. 

REFERENCES 

1. Pickering, G. W: The pathogenesis of malignant hypertension. Circulation 6, 
599-610, 1952. 

2. Beckman, H.: Pharmacology in clinical practice, p. 19&-203. W. B. Saunders, 
Philadelphia 1952. 

3. Allen, E.V.: Symposium on the treatment of hypertension. Proc. Mayo Clin. 

27, M'6-M\, 1952. 

4. Preis, E. D.: Recent advances in the medical treatment of essential hyper- 
tension with particular reference to drugs. Med. Clin. N. Amer. 52, 1247-1258, 

1948. 

5. Paton, W. D. M. and E. J. Zaimis: Actions and clinical assessment of drugs, 
which produce neuromuscular block. Lancet 2, 568-570, 1950. 

6. Graham, J. G. and A. Campbell: Absorption of Hexamethonium. Brit. med. 
J. /, 1514-1515, 1951. 

7. Rosenheim, M. L.: Medical treatment of hypertension. (Proc. roy. Soc. Med.) 
Lancet 7, 492-493, 1952. 



DISCUSSION 
Emil Glass 



I would like to emphasize the importance of the ganglionic 
blocking in the treatment of certain diseases. Years ago I introduced 
a method of blocking the ganglion sphenopalatinum by means of 
Isophenal (Doppler) for the treatment of headache due to spasm of 
the small vessels. Doppler was the first to introduce the so-called 
sympathicodiaphteresis; he used it as a Substitute for the Leriche opera- 

13 



tion to relieve the vascular spasm affecting the testicle. Blocking of 
the nasal sympathetic pathways may check severe headache, for 
instance of premenstrual headache. According to FHess, the blocking 
is achieved by cautherization of the tuberculum of the nasal septum 
or of the anterior portion of the middle turbinate. Ruskin obtained 
good therapeutic results in the treatment of backache by blocking the 
nasal ganglion in this vvay. The attempt seems justified to apply this 
method to the treatment of hypertension in lieu of the heroic surgical 
procedures presently used. The technique of the blocking method 
is simple, there is no risk involved, no pain and no side efTects. I had 
good results with this method in some cases of Buerger's disease. 



14 



INSECTICIDES 

Ludwig Teleky 



Devastation by insects and other animal pests is an old story and 
so is the fight against it. In the second book of Moses we read that 
God sent over the Egyptians a cloud of stinging flies, grasshoppers and 
house vermin. The Suggestion that fruit trees be treated with sulphur 
or tar vapors was made already 200 years before Christ. Since those 
antique ages man has made himself master of vast areas of the earth 
and tumed them to his own purposes: agriculture, cattlebreeding, 
forestry. The gravity of pest devastation and man's struggle against 
it have accordingly intensified. Sixty kinds of insects cause damage in 
the United States estimated at a yearly total of 1 1 ,600,000,000. In 
the fight against pests we consume, yearly, sixty-six million kilograms 
of lead and calcium arsenate, twenty-two million kilograms of DDT, 
and smaller quantities of many other substances. 

Both World wars added streng impetus to man's endeavor to find 
and test the efficacy of insecticides. In the last few years nearly five 
thousand substances have been tried out on insects and rodents. The 
Problems involved are not simple; diflerent insecticides must be used 
against difTerent insects, for diflerent plants, soils and seasons. For 
example: one animal may react to a poison quite differently from 
another animal - which indicates also how wrong it is to apply to 
human beings the results of animal experiments. In this connection 
let me mention a new rodenticide: a-N aphthylthiurea, "Antu". This 
kills norway rats and dogs but has practically no efTect on mice or 
squirrels. 

We cannot speak here of the various properties and peculiarities 
of diflerent insecticides, but we should mention the amazing fact that 



15 



certain insects build up resistance to particular poisons, an immunity 
that persists for generations. Thus in the United States generations of 
flies have now acquired resistance against DDT. 

In addition to the older poisons, such as the arsenates and hydro- 
cvanic acid, there are the new contact insecticides, which kill by con- 
tact alone. These may be grouped as follows: 

Halogenated hydrocarbons, including DDT, Chlordan, 

Benzenehexachloride 
Organic phosphates: Parathion, TEPP 

We have further: 

Organic sulphur Compounds 
Organic materials such as nicotine 
Organic mercury Compounds 
Lead arsenates, etc. 

It should be emphasized here that every insecticide has several com- 
mercial names, adopted by various firms and changing with the times. 

We shall speak here only of a few of the most important insecti- 
cides and their danger to human beings - the factory workers who 
produce them, and the farmers who apply them. - We will leam how 
to protect them and how to treat poisonings. 

Hydrocyanic Acid: Extremely dangerous. It can penetrate a thin 
wall, adheres to clothing and textiles. After it has been used as insecti- 
cide or rodenticide, rooms and textiles which have come in contact 
with it must be thoroughly aired for at least twenty-four hours. This 
poison is taken in by respiration and through the skin; it quickly 
causes unconsciousness, coma, death. The Reichsgesundheitsamt re- 
commended a treatment as early as 1942, which has since been im- 
proved upon by Chen and Rose ( 1 ) . First, Inhalation of amylnitrite 
from broken phials, then intravenous injection of 2.5-5 cm^ of a 3 % 
sodium nitrite Solution; instantly thereafter, with the same needle, 
25-50 cm^ of a 50 % sodium thiosulfate Solution. If necessary, repeat 
one hour later, in any case two hours later. The patient has to be 
observed for 24^8 hours and if necessary be treated again. 

16 



Organic Mercury Compounds. Commercial names: Ceresan, 
Germisan, Upsulan, etc. The clinical picture difTers from that of mer- 
cury poisoning. There is little or no saHvation or tremor, but we find 
vasomotoric disorders, hypoaesthesia in the lower extremities and 
j>sychic disturbanccs. 

Example: Two girls are working in a storehouse 15 feet away from some 
piles of dicthylene mercury. After 3 months of working they fall ill with gastric 
and nervous disturbanccs. In spite of treatment with BAL death occurs 6 wceks 
later. 

Contact Insecticides. According to Lehman (2) their relative 
toxicity for human beings is as follows: 



DDT 


1 


Chlordan 


/2 


Methoxy chlor 


1/24 


Parathion 


70 


TEPP 


125 



The most frequently used of these substances is DDT. It is supp- 
lied as a talcum powder containing 2-10 % DDT, and as a spraying 
liquid containing 6 % DDT in kerosene. Commercial names: Gesarol, 
Neocid, Duclid, etc. Up to 1951 there were 66 reported poisonings 
(one fatal) among agricultural workers, 263 poisonings (9 fatal) by 
accidental intake, and 22 poisonings by wilful intake, with 3 deaths. 

Light cases bring on loss of appetite, gastric Symptoms, buming 
of the eyes, dryness of the pharynx and irritability. Cases are reported 
among workers foUowing a single exposure to heavy dust clouds, as 
well as foUowing prolonged lighter contact, e.g., after an ovemight 
stay in freshly and too heavily dusted rooms. 

Klingemann ( 3 ) reports on a man who inhaled heavy clouds of 
dust for two or three hours and took in large quantities through his 
greased skin. He developed gastric Symptoms, paraesthesia, paresis 
and albuminuria. Recovery was very slow. There are also chronic 
cases. Stone and Gladstone (4) report disturbances of speech, vision 
and locomotion after 4 years of constant exposure. Hertel (5) reports 
the fatal outcome of such a chronic case. 



17 



'• 



For his protection the worker should have a respirator (tested 
by the United States Department of Agriculture) and natural rubber 
gloves. The workers should be shifted every two to four weeks; they 
should not engage in this kind of work for any length of time. Stone 
and Gladstone tried their patient with 400 mg. of nicotinic acid daily 
for 3 davs, then injected 1 50 mg. of thiamin daily for 6 days. 

Chlordan, called "Velsicol 1068", is absorbed by the skin. Reports 
on poisoning are few and not entirely clear. Symptoms seem to be 
vertigo, irritability, tremor. 

Benzenehexachloride and Pentachlorphenol (Baader and Bauer, 
6) are skin irritants, the latter also causing bronchitis and neuralgia. 
Dichlorhenzol ("Globol") was formerly believed to be innocuous, but 
on one occasion four persons who had been treating clothes against 
moths with this substance lost consciousness, showed a weak pulse, 
excitation, then vomiting ( 7 ) . 

Organic Phosphorus Compounds. They are far more dangerous 
than the halogenated hydrocarbons; Parat hion is the most widely 
used. The record on Parathion (called "E 605" or "Thiophos") 
up to the year 1950 shows 198 reported poisonings, including 7 fatal 
and 40 of serious nature. Of these cases 112 were farm workers (in- 
cluding 2 pilots), with 3 fataUties and 25 serious consequences. Para- 
thion is a black-brown, oily liquid which is used in the United States 
as a 1-2 % powder with talcum or as a 0.06 % emulsion. Parathion 
inactivates the enzyme choHnesterase. Parathion is taken in through 
the skin and by respiration. 

Case reports. A man working without a respirator feil ill at noon of the first 
day with vertigo, fainting, abdominal pains, vomiting, convulsions. 

A man who sprayed himself with Parathion failed to get cleaned properly. 
8 hours later there was nausea and tremor. Improvement set in after administra- 
tion of atropine, but death occurred 21 hours later (8). 

Another worker after being severely soiled with Parathion died within 
15 hours. 

But we have also reports indicating a more cumulative poisoning: 

A man worked for two weeks, 5 days a week, Alling spray apparatus. He feil 
ill, but recovered. A month later he started on the same kind of work again and 
died on the second day of the renewed contact. 

An entomologist worked for 4 months ofT and on with Parathion. One day 
he failed to use a respirator; after a few hours of working he died. 



To summarize, poisoning begins with nausea, vomiting, abdomi- 
nal pains, salivation, and myosis (eye disturbances may cause acci- 
dents among pilots spreading the substance from a plane), increase 
in blood pressure, oppression, bronchitis with heavy secretion, muscle 
spasms, tremor, restlessness; eventually, Stupor, confusion, convulsions 
and death may occur. Fatal outcome has been observed from one to 
2 1 hours f ollowing the exposure and from one to 1 3 hours after the 
appearance of the first Symptoms. 

The American Cyanamid Co., which produces Thiopos (Para- 
thion) in the United States, recommends the f ollowing Prophylaxis: 
Avoid Inspiration and contact with skin ; for this purpose use approved 
respirator and gloves of natural rubber, cover every part of skin. 
After work wash face, arms, hands and all soiled parts carefully. It is 
best to take a bath and clean the whole body thoroughly. When Symp- 
toms appear, call the doctor, but even before his arrival, if there is 
disturbed vision, abdominal pain, oppression, take two tablets of 
atropine, 0.6 mg. each. If the physician finds hyperhydrosis, myosis, 
lacrimation, salivation, he is to give 1.30-1.95 mg. atropine intra- 
venously every hour until dilation of the pupils occurs or until 19.5 mg. 
have been given. Give no morphine ! If there is bronchial stasis apply 
"postural drainage", if necessary artificial respiration. The acute 
danger persists from 24 to 48 hours. A man who has once been poi- 
soned should not work with Parathion again. 

A sensitive test for Parathion poisoning is the determination of 
Cholinesterase in red cells and plasma. A good method of detecting an 
impending poisoning would be the continuous control of the concen- 
tration of this enzyme. The first determinations must be made before 
the worker Starts handling organic phosphates, in order to obtain his 
normal choHnesterase values. Weekly examinations should be made 
thereafter. Upon the first appreciable drop of one of the Cholinesterase 
below the mean normal, the worker should be immediately removed 
from all possible contact with Parathion until a subsequent check 
indicates the retum to normal values. Gariik (9) applied this method 
with excellent results. However, the method is rather involved and 
requires facilities not readily obtainable in rural surroundings. 
TEPP is even more dangerous than Parathion. 



ra 



19 



In my opinion such extremely dangerous substances as the 
organic phosphates should not be used at all. The use of insecticides 
in general requires govemment regulation so that potential damage 
may be minimized and substances too perilous to man can be removed 

from the market. 

REFERENCES 

1. Chen, K. K. and C. L. Rose: J. Amer. med. Ass. 149, 113, 1952. 

2. Lehman, A.: Pests and their Control. July 17, 1949. 

3. Klingemann: Ärztl. Wschr. 1949, p. 465. 

4. Stone, T. T. and L. Gladstone: J. Amer. med. Ass. 145, 1342, 1951. 

5. Hertel, H.: Dtsch. Arch. klin. Med. 199, 256, 1952. 

6. Baader, E. W. and H. J. Bauer: Ind. J. Surg. 20, 286, 1951. 

7. Robber, H.: in Sammlung von Vergiftungsfällen. 1928. 

8. Bidstrup, P. L.: Brit. Med. J. 2, 548, 1950. 

9. Industr. Hyg. Newsletter 10, No. 9, 1950. 



20 



LEAD POISONING IN CHILDREN 

Frederick G. Zak 

A fatal case of lead encephalopathy in a child with pica is pre- 
sented. The diagnosis was not suspected clinically and based on the 
presence of acid-fast nuclear inclusion bodies in kidney and liver. 
Typical microscopic changes of the brain and a significant increase 
of lead in this organ corroborated this. 

The differential diagnoses are discussed from the Standpoints of 
the clinician and the pathologist. 



21 



SELECTED LEGAL TOPICS 
Albert Hirst 

I accept, with thanks, your invitation to discuss with you tonight 
certain legal subjects which may be of practical interest to you. I shall 
touch upon these topics: 

I. The unpleasant possibility that a physician may be sued both 
for malpractice and for breach of contract. 

II. Some legal aspects of the physician's duty to keep confiden- 
tial bis patient's Communications. 

III. Certain provisions of the Penal Law of interest to physicians. 

IV. Certain aspects of the law of Intestacy and Wills. 

I. 

We all realize the high Obligation we owe to those who come to 
US for professional help ; we realize that we owe them the highest duty, 
unflagging zeal and attention to their needs; we have no sympathy 
for the man who, careless of his professional Standards, injures those 
who come to him and has to respond in damages for wrongs he has 
inflicted. 

What concerns us, however, is the possibility, unfortunately not 
so remote, of the professional man being victimized by the crank or 
the crook. 

Now, what I wanted to bring out in this part of my discussion 
is the even more unpleasant f act that that crank or crook has the oppor- 
tunity of attacking a physician in two different ways. He may claim 
"malpractice". That term has been defined in Isenstein v. Malcomson, 
227, App. Div., 66, 236 N. Y. S. 641, 643, where the court said that 



22 



it has been "used to indicate a corrupt or culpably incompetent prac- 
titioner of either law or medicine". 

Now, in an action for malpractice, your defense can show that 
the methods which you used to treat the patient were the Standard 
methods recognized by the profcssion, that you used due care and 
that the unsatisfactory result was not your fault. 

Insurance companies make readily available to reputable physi- 
cians policies under which, in case of an action for malpractice, the 
insurance Company bears the entire expense of the defense and in 
case of an adverse outcome, pays the judgment that the patient may 
recover. 

I take it that so far I have told you nothing new. What I wanted 
to point out under this heading is the possibility, well established in 
our law, of an action by that same crank or crook not only for mal- 
practice, but in addition, on a theory of a breach of contract. Thus, 
one of our courts stated (Frankel v. Wolper, 181 App. Div. 485, 169 
N.Y. S. 15, 17): 

"I should say, that where a physician, with whatever prudence, agrees that 
his treatment will eure, and it does not, the patient is absolved from payment, 
may recover advances, may recover expenditures necessitated for nurses and medi- 
cines, and maybe for something eise." 

To make things worse, under our law, an action for malpractice must 

be commenced within two years after the act of malpractice has been 

committed. If not commenced within that period, it is forever barred. 

A Claim for breach of contract, however, may be asserted any time 

within six years. 

Let me give you the facts in Conklin v. Draper, 229 App. Div. 227, 241 
N. Y. S. 529, aff'd. 254 N. Y. 620. In that case, plaintiff was operated for appen- 
dicitis. The surgeon left an arterial forceps in the abdominal cavity. The error 
was discovered after the two years had elapsed during which an action for mal- 
practice could be commenced, but the court permitted the plaintiflf to sue for 
a breach of the contract which the defendants had made that the Operation "will 
eure". Significantly enough the defendants were the surgeon who performed the 
Operation, as well as the general practitioner who had assisted in the pre- and 
postoperational care. 

In another case*, the defendant had attempted to remove a cataract. The 
Operation was unsuccessful. The patient sued, claiming that insufficient anesthesia 

♦ Colvin V. Smith, 94 N. Y. S. 2^ 98, aff'd. 276 App. Div. 9, 92 N. Y. S. 2d 
794, 275 App. Div. 1018, 91 N. Y. S. 2d 713. 



23 



was given ; because of that insuf ficiency, the patient moved the eye during the 
Operation, which resulted in injuries. She sued the doctor in two separate actions, 
in each case claiming $ 20,000, one action for malpractice and the other one for 
breach of contract to eure. The courts held that she was entitled to maintain 
both cases. 

Let me stress the difficulties these defendant physicians were 
subjected to in cases where the patient claims that a contract was 
broken. You, as a physician, may know that a promise that your 
"treatment will eure" would be ridiculous. As a matter of fact, you 
may have wamed your patient that the possibility of success of the 
treatment is slight; you may even have discouraged continuance of 
the treatment. Just the same, the patient can come into court and claim 
that within the secrecy of your consultation room a conversation had 
taken place completely contrary to what actually was said; you will 
find yourself in the highly undesirable and dangerous position that 
there will be one person's word against the other's, with a jury left free 
to speculate whether to believe the patient or the physician, one of 
them obviously lying. 

This Situation is made all the more serious by the fact that you 
cannot obtain insurance to protect you against claims for breach of 
contract. Obviously, no insurer can undertake to protect a physician 
who, for all he knows, may have been making extravagant promises 
in Order to attract business. 

One consolation only can I offer - the damages recoverable in 
an action for breach of contract are likely to be considerably less than 
those in a malpractice action. Just the same, to be compelled to repay 
all fees received from the patient, to pay him for his expenditures for 
nurses and medicine, is an unpleasant possibiüty. 

I can only rctommend extreme care in predicting the outcome 
of treatments, by a physician or by a surgeon; to try, if possible, to 
have this type of conversation in the presence of a friendly witness, 
such as your nurse; and wherever possible, to obtain the patient's 
signed Statement showing that no agreement was made that your 
"treatment will eure". 



24 



IL 

The physician's duty to keep confidential what the patient has 
told him is too well known to call for discussion. What we shall discuss 
tonight are rather the exceptions to the rule : 

1. No duty to keep disclosures confidential exists where the 
relationship is not that of physician and patient. If, for instance, a 
person sues an accident and health insurance Company for disability 
benefits, or has been injured in an automobile accident and is suing 
in negligence, the defendant may arrange with you to examine the 
plaintifT ; in that case, of course, you are perf ectly free to disclose to the 
defendant not only your findings upon the examination, but whatever 
the plaintiff may have told you. You are not plaintiff's physician. 

2. Your patient may authorize you to disclose your medical 
findings, including the medical history which he gave you, to another 
party; you may have treated a plaintifT whose medical Status is now 
involved in litigation. Now, in any such Situation, when your patient 
authorizes you to disclose your medical record to an outsider, it is 
advisable that you do not act, except upon your patient's written 
authorization. If you act under such a written authorization, it is 
essential that you insist that the writing be delivered to you and that 
you retain it in your files so that at any time in the future, you can 
protect yourself against any possible claims that your disclosures were 
not authorized. 

3. You may be called to court as a witness. Such a call may come 
in two different forms: a) you may appear in court by arrangement, 
or b) you may appear under subpoena compelling you to attend. If 
you are subpoenaed, you are entitled to only the statutory witness fee 
which is trifling. It is quite proper, however, for you, whether you 
appear voluntarily or under the compulsion of a subpoena, to accept 
from the party that calls you to court, in addition to the witness fee, 
adequate compensation for your loss of time. 

If you appear as a witness, whether voluntsuily or under sub- 
poena, the protection of your patient's confidential communication 

25 



has passed out of your hands. As a witness in court, it is your duty to 
answer all questions asked of you; it is up to the lawyer and not to you 
to object to questions if he considers that they call improperly for 
disclosure of confidential information. You can never be criticized for 
answering freely any question you are asked in court or in any judi- 
cial proceeding. 

There is one additional bit of information that I would Hke to 
leave with you - certain matters that you personally, may consider 
confidential are not confidential as a matter of law. Even over objec- 
tion, I can force you to disclose the dates when a person consulted 
you; I can also force you to answer the question whether on these 
occasions the person was well or sick. I cannot go further, but I can 
go that far. These questions you may safely answer to a stranger even 
though he does not have your patient's authorization. 

III. 

In this discussion, I shall confine myself to the Penal Law of tliis 
State; I take it that everyone in this audience is more or less familiär 
with his duties and liabiUties under the United States Food and Drugs 
Act or the provisions of Federal law dealing with narcotics; as to nar- 
cotics, these are regulated by Federal and by State law ; none of these 
matters shall I discuss tonight. 

Again I shall confine myself to telling what the law is; this, 
I take it, is not the time and place to discuss what the law ought to be. 

1. Adultery is defined in § 100 of the Penal Law to be: "Adultery 
is the sexual intercourse of two persons, either of whom is married to 
a third person". It is a misdemeanor. It is punishable by imprison- 
ment up to six months or by a fine of ? 250. The possibility of pro- 
secution for adultery is extremely slight. The type of evidence which 
is ample in an action for divorce is not sufficient in a criminal pro- 
secution. l'here, the district attorney would have to prove "beyond 
a reasonable doubt" that intercourse actually took place. The mere 
finding of the parties alone in a hotel room, for instance, would not 
be sufficient. 



26 



2. Abortion. 

"§ 80. Definition and punishment of abortion 

A person who, with intent thereby to procure the miscarriage of a woman, 
unless the same is necessary to preserve the life of the woman, or of the child with 
which she is pregnant, either: 

1. Prescribes, supplies, or administers to a woman, whether pregnant or 
not, or advises or causes a woman to take any medicine, drug, or substance; or, 

2. Uses, or causes to be used, any instrument or other means, 

Is guilty of abortion, and is punishable by imprisonment in a State prison 
for not more than four years, or in a county jail for not more than one year." 

"§ 81. Killing of child in attempting miscarriage 

A pregnant woman, who takes any medicine, drug, or substance, or uses or 
submits to the use of any instrument or other means, with intent thereby to pro- 
duce her own miscarriage, unless the same is necessary to preserve her life, or 
that of the child whereof she is pregnant, is punishable by imprisonment for not 
less than one year, nor more than four years." 

"§ 81-a. Witnesses' Privileges 
A female who has violated section eighty-a of this article or who has com- 
mitted an attempt to violate such section shall not be excused from attending and 
testifying or producing any evidence, documentary or otherwise, in any investi- 
gation or trial relating to violations of sections eighty, eighty-one, eighty-two, ten 
hundred and fifty, or eleven hundred and forty-two of this chapter, or an attempt 
to commit any such violation, upon the ground or for the reason that the testi- 
mony or evidence, documentary or otherwise, required of her, may tend to con- 
vict her of a crime or to subject her to a penalty or forfeiture; but no such female 
shall be prosecuted or subjected to any such penalty or forfeiture for or on account 
of any transaction, matter or thing conceming which she is compelled, af ter having 
claimed her privilege against self-incrimination, to testify or produce evidence, 
documentary or otherwise, and no testimony so given or produced shall be received 
against her upon any criminal investigation, proceeding or trial*". 

"§ 82. Selling drugs or instruments to procure a miscarriage 
A person who manufactures, gives or sells an instrument, a medicine or 
drug, or any other substance, with intent that the same may be unlawfuUy used 
in procuring the miscarriage of a woman, is guilty of a felony." 

"§1050. Manslaughter in first degree 

Such homicide is manslaughter in the first degree, when committed without 
a design to effect death: 

« « * 

The wilful killing of an unbom quick child, by any injury conmiitted upon 
the person of the mother of such child, is manslaughter in the first degree. 

A person who provides, supplies, or administers to a woman, whether pre- 
gnant or not, or who prescribes for, or advises or procures a woman to take any 
medicine, drug, or substance, or who uses or employs, or causes to be used or 

« In other words, the female may freely testify against the accused physician. 

27 



3 Virchow Society, Vol. 12 (1953) 



employed, any Instrument or other nieans, with intent thereby to procure thc 
miscarriage of a woman, unless the same is necessary to preserve her life, m case 
the death of the woman, or of any quick child of which she is pregnant, is thereby 
produced, is guilty of manslaughter in the first degree." 

You will notice that § 80 defines the crime of abortion to be 
procuring "the miscarriage of a woman, unless the same is necessary 
to preserve the life of the woman, or of the child with which she is 
pregnant". I hardly need mention to this audience the well known 
practice that a surgeon before performing an abortion will have the 
case diagnosed by one, or preferably more than one, independent 
physicians and that he will not operate unless they certify in writing 
that the Operation is necessary for the preservation of hfe. 

3. Contraceptives. The law applicable to the use of contraceptives 
is found in §§ 1 142, 1 142-a and 11 45 of the Penal Law. They read: 

"§ 1142. Indecent articles 

A person who sells, lends, gives away, or in any manner exhibits or ofFers 
to seil, lend or give away, or has in his possession with intent to seil, lend or give 
away, or advertises, or offers for sale, loan or distribution, any Instrument or 
article, or any recipe, drug or medicine for the prevention of conception, or for 
causing unlawful abortion, or purporting to be for the prevention of conception, 
or for causing unlawful abortion, or advertises, or holds out representations that 
it can be so used or applied, or any such description as will be calculated to lead 
another to so use or apply any such article, recipe, drug, medicine or instrument, 
or who writes or prints or causes to be written or printed, a card, circular, 
Pamphlet, advertisement or notice of any kind, or gives information orally, stating 
when, where, how, of whom, or by what means such an instrument, article, 
recipe, drug or medicine can be purchased or obtained, or who manufactures any 
such instrument, article, recipe, drug or medicine, is guilty of a misdemeanor, 
and shall be liable to the same penalties as provided in section eleven hundred 
and forty-one of this chapter." 

§ 1 142-a. Advertisements relating to certain diseases prohibited. Whoever 
publishes, delivers or distributes or causes to be published, delivered or distributed 
in any manner whatsoever an advertisement concerning a venereal disease, lost 
manhood, lost vitality, impotency, sexual weakness, seminal emissions, varicocele, 
self-abuse or excessive sexual indulgence whether described by such names, words, 
terms or phrases, or by any other names, words, terms or phrases, calculated or 
intended to convey to the reader the idea that any of said diseases, infirmities, 
disabilities, conditions, or habits are meant or referred to, and calling attention 
to a medicine, article or preparation that may be used therefor or to a person 
or persons from whom or an oflFice or place at which information, treatment or 
adyice relating to such disease, infirmity, habit or condition may be obtained, is 
guilty of a misdemeanor and upon conviction thereof shall be punished by im- 

28 



prisonment for not more than six months, or by a fine of not less than fifty doUars 
nor more than five hundred doUars, or by both such fine and imprisonment. This 
section, however, shall "not apply to didactic or scientific treatises which do not 
advertise or call attention to any person or persons from whom or any ofTice or 
place at which information, treatment or advice may be obtained, nor shall it 
apply to advertisements or notices issued by an incorporated hospital, or by a 
licensed dispensary, duly certified by the local board of health as a venereal 
disease clinic, or by a municipal board or department of health or by the depart- 
ment of health of the State of New York". 

"§ 1145, Physicians' instruments 

An article or instrument, used or applied by physicians lawfully practising, 
or by their direction or prescription, for the eure or prevention of disease, is not 
an article of indecent or immoral nature or use, within this article. The supplying 
of such articles to such physicians or by their direction or prescription, is not an 
offense under this article." 

Our highest court, the Court of Appeals, has said in People 
V. Sanger, 222 N. Y. 192, 194, 195, after quoting § 1 145, that: 

"This exception in behalf of physicians docs not pcrmit advertisements 
regarding such matters, nor promiscuous advice to patients irrespective of their 
condition, but it is broad enough to protect the physician who in good faith 
gives such help or advice to a married person to eure or prevent disease. 'Disease,' 
by Webster's International Dictionary, is defined to bc, 'an alteration in the State 
of the body, or of some of its organs, interrupting or disturbing the Performance 
of the vital functions, and causing or threatening pain and sickness; illness; sick- 
ness; disorder.' 

The protection thus afforded the physician would also extend to thc 
druggist, or vendor, acting upon the physician's prescription or order*". 

It may also be of interest for you to know that in the case of 
Barretta v. Barretta 46 N. Y. S. 2^ 261, a wife sued her husband for 
Separation. He defended on the ground that the wife had refused any 
sexual relations with the husband unless he would use a contraceptive. 
The judge said: 

"A wife who demands benefits under the marriage contract must provc 
that she is willing to discharge her obligations under it. The rcfusal of a wife 
without adequate excuse to have ordinary marriage relations with her husband 
strikes at the basic obligations of the marriage contract. Here she seeks the benefits 
of that contract while violating one of the fundamental obligations of it. Our law 
does not permit her to recover. Mirizio v. Mirizio, 242 N. Y. 74, 150 N. E. 605, 
44 A. L. R. 714; Downes v. Downes, 225 App. Div. 886, 233 N. Y. S. 39." 

The court refused to allow any alimony to the wife. 

* In other words, only if you honestly belle ve that contraceptives are needed 
to eure or prevent disease may you prescribe them. 



29 



4. Rape. Rape in the ordinary sense, is defined m § 2010 and 
we shall not discuss it herein. I point out to you, however the follow- 
ing definition of rape in the second degree as found m § 2010 of the 
Penal Law. 

"A person of the age of twenty-one years or over who perpetrates an act of 
sexual k^tercourse with a female, not his wife, ander the age of eighteen years, 
unde drcurstances not amounting to rape in the first degree, - ^-Ity «f ^^^^^ 
in the second degree, and punishable with impnsonment for not more thai. ten 

^'^"'a person who perpetrates an act of sexual intercourse with a female, not 
his wife, under the age of eighteen years, under circumstances not amountmg to 
rape in (he first degree or rape in the second degree is guilty of a misdemeanor ** . 

The very serious aspect of rape in the second degree, or, as it is 
often called statutory rape, is that the crime is conunitted and the 
defendant is guilty even though he did not know the age of the female 
and, as a matter of fact, was misinformed by her as to her true age. 
I quote the following from People v. Marks 146 App. Div. 11, 130 
N. Y. S. 524, 525 where the Appellate Division said of § 2010: 

"By that enactment, and the statutory provisions from which it was taken, 
the Legislature in its wisdom determined to make the crime dependent upon the 
age of the female, and thereby intercourse with a female the day before she attairis 
the age of 18 years, if not under circumstances constituting the crime of rape m 
the first degree, is a fclony; but it would not be a crime at all, unless under an- 
other Statute relating to adultery, if the intercourse took place the day after. 

The manifest purpose of this legislation was to protect the morals of young 
girls; and, to render the enactment efTective, neither the consent, nor the previous 
unchastity of the girl, nor her representations nor information derived from others 
as to her age, nor her appearance with lespect to age is a defense to a prosecution, 
but such facts may doubtless be taken into consideration by the court in passing 
sentence* * *." 

5. Crime against nature; sodomy. § 690 of the Penal Law pro- 
vides, in part: 

"A person who carnally knows any male or female person by the anus or 
by or with the mouth against the will and without the consent of such other 
person; or, 

« « * « 

5. When such other person is, at the time, unconscious of the nature of 
the act, and this is known to the defendant ; or when such other person is in the 
custody of the law, or of any officer thereof, or in any place of lawful detention, 
temporary or permanent; or, a person who carnally knows in any manner any 



30 



animal or bird; or attempts sexual intercourse with a dead body, is guilty of 
sodomy in the first degree and is punishable with imprisonment for not more than 
twenty years or with imprisonment for an indeterminate term the minimum of 
which shall be one day and the maximum of which shall be the duration of his 
natural life. 

A person twenty-one years of age or over who carnally knows by the anus 
or by or wäth the mouth any male or female person under the age of eighteen 
years, under circumstances not amounting to sodomy in the first degree is guilty 
of sodomy in the second degree and punishable with imprisonment for not more 
than ten years. 

A person who carnally knows any male or female person by the anus or by 
or with the mouth under circumstances not amounting to sodomy in the first 
degree or sodomy in the second degree is guilty of a misdemeanor." ♦ * ♦ ♦ 



In concluding our discussion of the Penal Law, may we point 



out: 



1 . In cases of rape and crime against nature, the slightest sexual 
Penetration is sufficient to complete the crime. 

2. In any prosecution for adultery, for rape or for crime against 
nature, no conviction can be had on the uncorroborated testimony of 
the complaining witness. 

3. In so far as any complaint against a physician is concemed for 
any violation of the Penal Law, we should realize that entrapment is 
perfectly legal. In other words, the unknown patient who comes to 
you may be a detective trying to entrap you into a violation of law. 

IV. 

In this final part of my talk, I propose to discuss a matter that 
concems you, not in your capacity as physicians, but as family men. 
I would like to call to your attention certain aspects in which our 
System differs from the legal Systems used on the Continent of Europe. 

1 . It is my understanding that in European countries where the 
civil or Roman law prevails, wills can be made very informally. For 
instance, I understand that, over there, if you write out your will with 
your own hand and sign it, it is perfectly good. Such a will has no 
eflect whatever in this State. Here, while the law does not require 
that the will must be prepared by a lawyer, it does require certain 
formalities in its execution. The testator must sign the will at the end, 



31 



he must do so in the presence of at least two witnesses to whom he 
must declare that he is signing his wUl and he must ask them to sign 
as witnesses. The witnesses must see him sign and they must sign in 
his presence and in the presence of each other. A will not so executed 
is not a will. 

2. Again, I understand that under European Systems, regardless 
of your intentions, your wife and children each are entitled to a cer- 
tain minimum share in what you leave at death. In this State, on the 
other hand, the only person who can insist on a certain minimum 
share, with exceptions not important to us tonight, is the widow or 
the widower; children have no claim of inheritance that a parcnt 
must respect. You are perfectly free, for no reason whatever, to dis- 
inherit some or all of your children. 

3. It is my impression that in Europe, the heirs quite informally 
take over what has been left to them and that they do so directly. 
That is not our System. A person appointed by the court, which is, 
incidentally, called the Surrogate's Court, handles all the affairs of 
the deceased; collects the assets, pays the debts, prepares tax retums, 
pays the income and inheritance taxes, and after all that is done, 
distributes the balance of the estate to those entitled thereto. If you 
die leaving a will in which you appoint a person to handle your 
aflPairs, the person is called an "executor"; if you die without a will, 
the person appointed to handle your affairs is called an "admini- 
strator". 

Both executors and administrators are entitled to certain com- 
pensation which is regulated by law. Their function is important. It is 
important, therefore, for you to decide by your will who should handle 
your estate because otherwise, the Surrogate will select an administra- 
tor under certain impersonal rules that the law lays down. 

Another important fact for you to know is that your executor 
acts without fumishing a surety Company bond. An administrator 
must fumish such a bond. The premium for a bond is high and the 
expense is considerable. Thus, the simplest kind of will naming an 
executor is likely to save your family quite a good deal of money. 



32 



4. I do not know what provisions Continental laws make for the 
protection of the property of minors. In this State, the protection of 
minors' property il very rigid. If you die intestate and your inf ant child 
becomes entitled to an inheritance, it will be entrusted to a court 
appointed guardian. The guardian usually is the child's parent, but 
again must furnish an expensive surety Company bond for the pro- 
tection of the minor. This bond must be renewed every year during 
minority. The minor's funds, be they capital or income, cannot be 
expended without court approval. If the inf ant is to be supported 
out of what you left him, a lawyer must be hired every year to file an 
accounting; if any money is to be used for the infant's education, 
maintenance and support, the Surrogate must authorize the expen- 
diture in advance. 

While these rigid rules are effective in protecting minors' funds 
from conversion and theft, they are very burdensome. You may, how- 
ever, in your will, dispense with all of these safeguards. You can do 
that in a variety of ways; if your property is not large in amount, 
it may be wise to leave everything to your widow and nothing to your 
children, trusting to the mother to take care of her own children ; or, 
you may leave some money to your children giving your widow or 
other relatives füll authority to spend it on behalf of the child as they 
deem best. 

5. In more substantial estates, a device, which I understand is 
unknown on the Continent, but in common use in this country is the 
creation of a trust. By this device, you take away the bürden of 
management of investments from your wife and children and entrust 
it either to competent friends or to a trust Company. In certain cases, 
the device has also substantial tax advantages. 

6. In every estate beyond the smallest, we are seriously concemed 
with tax Problems; income taxes as well as inheritance taxes, have 
to be considered and considerable savings can be efTected by using 
proper measures. If you make no will, you cannot do that. 

7. Finally, may I say that we here in this country use life in- 
surance f ar more extensively than do Europeans. We use it to provide 
guaranteed and frequently income tax free incomes for our widows 

33 



and orphans; to pay the mortgage on the home; to pay estate taxes; 
to provide College funds for the children. Life Insurance here is abso- 
lutely safe; life Insurance companies do not fall. They meet their 
obligations promptly. 

It is customary when one prepares one's will at the same time to 
make certain agreements with the life insurance companies about the 
method of their paying the death benefits. The disposition of your life 
insurance and of the rest of what you leave are intimately related 
and should be considered together. 

These matters are of special importance to the family of pro- 
fessional people who are not usually included among the beneficiaries 
of the social security System. 

In Conclusion 

It is difficult for a lawyer to guess how much of legal subjects 
physicians will know. I cannot flatter myself that I have told you 
much that is new to you. I hope, however, that I have succeeded in 
stimulating your thinking in one or the other respect. In any event, 
let me thank you for the patience with which you have listened. 



34 



PSYCHIATRIC ASPECTS OF CRIMINAL 

BEHAVIOR 

Leo L. Orenstein 



What is criminal in human behavior is defined by legal rather 
than medical criteria, and depends on social and cultural deter- 
minants. Human behavior, whether criminal, or otherwise falls within 
the province of Psychiatric investigation. The psychiatrist must con- 
cem himself with the careful examination of the criminal, that is the 
conscious manifestations and unconscious motivations observable 3nd 
discemable in those accused and convicted of crime. By definition 
one is a criminal after apprehension and conviction only. This does 
not mean that so called asocial tendencies are Umited to those adjudi- 
cated in our courts of law ; nor does it f ollow that adjudication always 
proves beyond any doubt that the subject is a criminal. 

Evidence has been collected and recorded in the literature 
(Borchard; Orenstein) indicating that innocent people may at times 
be convicted on charges of criminal acts. While this occurs in- 
frequently, it does occur, and is most likely to happen in instances 
involving moral and ideological issues. It is our opinion that Psychia- 
tric investigations may prove very helpful in clarifying existing con- 
fusions, and this efTort could be even more productive if our laws were 
permissive or helpful in subjecting complaining witnesses to Psychiatric 
examinations, just as they are conceming the accused. 

Since the responsibility of the psychiatrist is to investigate the 
criminal and not the crime, he must leave the latter to bis associates 
in the legal and police professions. It remains the obUgation of the 
psychiatrist to evaluate the person of the criminal, make a diagnosis, 
establish legal responsibility, and report the same. It remains for the 

35 



court and juries to determine the legal meaning and relevance of the 
medical facts presented by the psychiatrist. 

Crimes are commitled by psychotic and mentally defective per- 
sons. However, the majority of criminals are legally responsible for 
their acts, even though many show evidence of major disturbance m 
their character structure. It should be kept in mind that in some, 
neurotic traits are acted out in such ways as to lead to serious conflict 
with the law. The periodic appearance of headlines concerning the 
criminal who is insane is less threatening to our public safety and 
welfare than such headlines might imply. Sex crimes particularly 
attract much attention, and even though 17 states have enacted 
special legislation to deal with sex offenders, the basic question in this 
area is far from resolved. 

There is much opportunity, challenging though it may be, for 
the psychiatrist in the field of penolog>^ This should, and ultimately 
may broaden its horizons in the direction of rehabilitation and even 
therapy in a f ulier medical sense. 

In our approach to the therapeutic and preventive aspects of 
crime cognizance has to be taken of practica! limitations. It is useless 
to become preoccupied with theories unless they are practica], laws 
unless they are meaningful, and ideas unless they are workable. The 
psychiatrist interestcd in crime realizes the limitations relative to all 
other phenomena in nature, and does not anticipate Utopian Solu- 
tions. However as a physician cognizant of the great strides made in 
this field, and the many more challenging possibilities for the future, 
the psychiatrist readily accepts bis Obligation to participate in a for- 
ward moving rather than Status quo medical and social effort. 



36 



MEDICAL ASPECTS OF ULCERATIVE COLITIS 

Charles I. Krieger 



Ulcerative Colitis, also known as Colitis gravis, was described by 
Wilke and Moxon as a separate disease entity as far back as 1875. 
But it was only after Worid War I that chronic ulcerative Colitis was 
recognized as one among various other diseases of the colon associated 
with ulcer formation. Subsequently, the diflerential diagnostic criteria 
were established. However, there are still a few who consider chronic 
ulcerative Colitis and chronic dysentery to be of common origin. 

We know acute forms of the disease with sudden onset, high 
fever, Woody and mucous stools. On proctoscopy, there are ulcerative 
processes which look very similar to those seen in acute dysentery. 
Since this type of ulcerative Colitis gives all the Symptoms of an acute 
infectious disease of the large bowel, considerable efTorts have been 
made to identify a specific organism as the etiologic agent (Bargen). 
The results were not conclusive and it is the present consensus that 
the bacterial flora is non-specific and plays no role in the etiology of 
the inflammatory process. The same holds true for certain viruses iso- 
lated from the mucosa. However, such secondary infections lead to 
further damage of the intestinal wall and contribute to the seriousness 
of the process. 

Allergy, imbalance of the autonomous nervous System, and nutri- 
tional deficiencies have also attracted attention as potential etiologic 
factors. All 3 have been shown to effect experimental changes (blood 
and lymph supply) in the colon similar to those associated with 
ulcerative Colitis. 

Ver>' much emphasis has been placed lately on the psychologic 
aspects which will be discussed by Dr. Meyer. In my own opinion, 

37 



there can be no doubt that in ulcerative Colitis, as in peptic ulcer, 
"stress" plays an important part in producing localized lesions, pro- 
vided the person is prone to such a psychosomatic reaction. If we 
accept ulcerative Colitis as a disease of stress in persons with neurotic 
traits, there is still the problem of what the mechanism of the reaction 
may be both as to localization and pathogenesis of the intestinal lesions. 

The importance of the psychogenic factor in the clinical picture 
of the disease is almost generally accepted. An ailment causing dis- 
ability for a long period of time involving remissions and relapses, 
puts a tremendous strain on the paticnt. Altemating disappointment, 
and optimism, periods of pain, disturbed nights, loss of weight, 
inability to lead a normal social Hfe - all this may imperil the balance 
even of well adjusted persons. 

In Order to establish a diagnosis we have to rule out a number 
of related conditions. Bacillary dysentery, acute and chronic forms of 
amebic Colitis, an irritable colon, tuberculosis, regional ileitis, nutri- 
tional deficiency, primary congenital polyposis of the colon, and 
lymphogranuloma venerium are the most important diseases which 
should be considered. 

The onset of ulcerative Colitis is gradual, sometimes acute, very 
rarely fulminating. According to Palmer, 97 % of the cases show 
rectal involvement on proctoscopy. The Observation of 2000 cases by 
Sloan, Bargen and Gage showed clearly that the most frequent type 
of disease involves the rectum and to a greater or lesser extent the 
entire colon. The milder form progresses slowly from the rectum to 
the sigmoid and colon. The process may be continuous for many 
years, heal and show relapses with further progress proximally. It is 
important to note that there is no direct correlation between the 
extent of the lesion and the clinical Symptoms. Patients with extensive 
lesions of the rectum and sigmoid may complain of constipation, com- 
bined with some tenesm and expulsion of mucus with or without 
blood. On the other hand a process identified by proctoscopy and 
x-ray examination as relatively mild may produce violent pain and 
tenesm, as well as loose and bloody stools. We have seen cases with 
only a few loose bowel movements, which showed extensive polypoid 

38 



changes. The severest forms of the disease, with narrowing, scar for- 
mation and polypoid changes throughout the whole colon occasionally 
go into complete remission with formed, regulär bowel movements 
and with little pain. Time does not i>ermit to describe in detail the 
different proctoscopic pictures at the various stages of the disease. 
However, I may assure you that protoscopy in the hands of the 
experienced physician will almost always establish the diagnosis, the 
type, and the stage of the disease. 

The two most frequent complications are stricture (in about 
10%) and polypoid changes (in almost 20% of the cases). Most of 
the strictures are localized in the rectum and sigmoid; they do not 
interfere with the transport of fecal material. It must be kept in mind 
that ulcerative Colitis may be a complication of primary [X)lyposis of 
the Colon. 

As to the relationship between chronic ulcerative Colitis and 
Cancer, recent reports show that Carcinoma occurs more frequently in 
patients with ulcerative Colitis than in the average population ( Kasich, 
Weingarten and Brown: in 7 of 143 cases = 4.9%; Kiefer, Eytinge 
and Johnson: in 10 of 226 surgical cases = 4.4%, and in 9 of 458 
non-surgical cases=2%; Lyons and Garlock: in 9 of 226 surgical 
cases = 3.9 %). These figures alone are not alarming wouldn't it be 
for the fact that observed malignancies concemed relatively youthful 
patients, that multiple foci were present and that the tumors were 
highly malignant and metastasized frequently. Alvarez has stressed 
these points. The factors of age and of duration of the disease should, 
therefore, be taken into consideration when the indication of surgery 
comes up. 

That ulcerative Colitis during its prolonged course impairs the 
balance of fluid, electrolytes, and nitrogen, and causes nutritional de- 
ficiency and anemia is not surprising. The severest cases show extreme 
loss of weight and complete emaciation, a picture of pity and sorrow. 
What happens to metabolism and nutrition in milder cases when 
they extend over years is not yet sufficiently known. From a paper of 
Posey and Bargen it would app>ear that severe metabolic derange- 
ments may be presented at a time when the disease still causes rela- 



39 



tively mild Symptoms. Such frequently described signs as glossitis, 
cheilosis, and raw beef tongue are commonly interpreted as vitamin 
deficiency. 

Impairment of adrenocortical function is suggested by the fre- 
quently diminished urinary excretion of 17-Ketosteroids and increased 
excretion of corticosteroids. The Sedimentation rate is increased in 
Proportion to the severity of the disease. Leucocytosis is missing even 
in severe cases. Defective intestinal absorption due to abnormally fast 
passage of food prevents utilization of part of the food intake. Nitrogen 
balance becomes negative (Sappington and Bockus), calcium loss 
causes demineralization of bones. A significant potassium deficiency 
was reported by Smith, Pollard and Bolt, but not confirmed by others. 
Our own observations revealed quite frequently low serum potassium, 
low Chlorides and low sodium, sometimes combined with metabolic 
alkalosis. Hypoproteinemia is frequently present. Patients in the State 
of malnutrition usually have very low BUN. This might be due in 
part to an inability to synthesize protein and this, in tum, might be 
the result of diminished production of those corticosteroids which are 
needed for the anabolism of protein. 

Hepatic disturbances in ulcerative Colitis are frequently men- 
tioned in the literature, but their significance and origin has still to be 
explained. Fatty Infiltration or cirrhosis of the liver are common 
findings. The question of liver damage has been recently investigated 
by Kleckner, Stauffer, Bargen and Dockerty by combined use of 
hepatic function tests and needle biopsy. The findings in 32 cases 
were as follows: Normal: 5 cases; fatty Infiltration: 9 cases; pericho- 
langitis: 3 cases; p>ericholangitis with stasis of bile: 3 cases; diffuse 
hepatitis: 2 cases; necrosis: 1 case; cirrhosis: 6 cases; metastatic 
Carcinoma: 3 cases. 

In 6 patients who had no clinical or laboratory evidence of 
hepatic dysfunction, only 2 had normal findings on biopsy. This con- 
firms the commonly held view that liver damage is a f requent attribute 
of ulcerative Colitis. 

That renal changes may develop on the same basis seems possible. 
Jensen, Baggenstoss and Bargen's postmortem studies of 64 cases 



40 



revealed that glomerular tuft proliferation was present in 70 % of the 
patients and most pronounced in the active cases. Tubulär degenera- 
tion and necrosis were found in 23 %, acute Pyelonephritis in 6.7 %, 
renal calculus in one case. Compared with other severe chronic diseases 
of various kinds, chronic ulcerative Colitis showed the highest inci- 
dence of renal damage, a fact which should reflect uf>on the indication 
of surgery. 

The therapy of ulcerative Colitis is one of the most difTicult and 
complex Problems. The character and the features of the disease are 
of such a diversity that we have to ad just the management to the 
ever-changing clinical Situation. To retain the confidence of the 
patient and his family during the prolonged course of the ailment is 
a task very hard to achieve. On the other band, the results may be 
less satisfactory if the patient has not complete confidence and is not 
willing to cooperate to the füllest extent. I can give you only an out- 
line of the most important therapeutic procedures. 

There has always been the general tendency towards an undue 
restriction of the diet, emanating from the idea that a non-residue 
diet is required by the presence of inflammatory intestinal lesions. Such 
a diet must become harmful if given for a prolonged period of time. 
The proper regimen should supply plenty of protein ( at least 120 g. ) 
and as many additional calories as the patient tolerates, restricting 
the total amount of fat. The tolerance for milk is generally poor. 
Fruits are valuable, but are apt to produce diarrhea in many cases. 
Fresh orange juice is preferable because it is rieh in potassium. 
Replacement of water, electrolytes and nitrogen is of great importance. 
Blood transfusions are often needed to restore volume and protein 
level of the vascular compartment. Frequent blood counts and serum 
analysis for electrolytes must supply the criteria upon which the 
amount and kind of parenteral fluid therapy depends. The necessity 
of vitamin replacement is understood. 

As to medication, anti-spasmodics are very valuable. Opium and 
its derivatives should be given with caution. When the first sulfa drugs 
became available, expectations were high. Today we know that only 
preparations which largely escaf>e absorption from the intestinal tract 



41 



have beneficial effect. Sulfathalidine (Phthalysulfathiazole) and Sul- 
fasuxidine (Succinylsulfathiazole) are the preparations of choice. 
They act primarily on the gram-negative flora of the intestines. Their 
therapeutic vaJue in ulcerative coUtis is not uniform. Patients with 
acute exacerbations may benefit temporarily from the medication, for 
instance, prior to surgery. The latest addition to these drugs is azul- 
fidine, suggested by Svartz in Stockholm in 1940. It is gradually 
decomposed in the body to 5-AminosaUcyHc acid and Sulfapyridine. 
To reduce the incidence and severity of side eflects, the well known 
precautions must be observed and one should control the Output and 
composition of urine as well as the blood count. As a whole, the value 
of sulfa drugs in the treatment of the acute and chronic phases of the 
disease is very limited. 

Equally disappointing are the results obtained with antibiotics. 
There is no doubt that the bacterial flora can be influenced, even 
selectively, by the various preparations, when administered orally or 
parenterally. However, this effect is short and soon the bacterial count 
retums to or exceeds its original level. The antibiotics are valuable 
only in the acute flare-up and in the pre-operative management. The 
evaluation of the various antibiotics with respect to these two indi- 
cations is still incomplete. 

Finally, we have to discuss the therapeutic value of ACTH and 
Cortisone. The observations gathered thus far cover a period of not 
more than 3 years, but give sufficient proof that the beginning of a 
new area in the treatment of ulcerative Colitis is at band. A critical 
analysis of the available studies indicates that the majority of observers 
consider ACTH or Cortisone as an eflective remedy at one time or 
the other. A few authors disagree and discourage the use of either 
one (Rosmiller, Brown and Ecker, Redish). Our own experience 
correlates well with that of Wirts-Carrol and Kirsner- Palmer who are 
convinced that ACTH is very valuable as an adjunct in the treatment 
of idiopathic ulcerative Colitis. I feel that ACTH should be given a 
trial whenever the clinical condition Warrants it, but that such a 
treatment requires hospitalization under any circumstances. I would 
not use these potent substances in mild cases unless all the other 
methods of internal therapy have failed. Patients who have a recur- 

42 



rence and are in good nutritional condition should not be subjected 
to ACTH injections and their potential side effects. Patients who have 
their first attack and show fulminating Symptoms should receive an 
early course of treatment with ACTH. Quick response and complete 
restoration of the mucosa has been reported not infrequently. We had 
always thought that the anatomic lesions as seen on proctoscopy could 
hardh vanish as the result of any therapeutic procedure in so short a 
time. Yet, their rapid disappearance during administration of ACTH 
is a matter of record. Additional improvements consist in the decline of 
fever, and the number of bowel movements, the restoration of electro- 
lyte balance, an increase in blood formation, gain in weight, and 
return of appetite. Furthermore, the patient will usually develop the 
euphoria that is so well known as a result of ACTH administration. 
If one observes such a drastic change in a severely ill patient, extreme 
caution is indicated not to overrate the significance of such an appa- 
rent improvemeiit On the other band, to bring about a remission by 
use of ACTH is an achievement that should not be underrated. It 
even seems as if we can sustain such remissions and prevent recurrences 
from getting out of control. 

The risks and benefits of prolonged endocrine therapy with 
ACTH or Cortisone are not yet fully understood. Among the known 
complications are masked Perforation of peptic ulcer and ulcerating 
areas of the colon, the development of psychosis, and the production 
of hyperadrenocorticism. 

Whether ACl H or Cortisone is of greater efficiency in these 
therapeutic endeavors, has not yet been decided. I have seen patients 
who did not respond to ACTH but improved with Cortisone, and vice 
versa. The quiekest response is achieved by intravenous administration 
of ACTH. Most authors feel that sulfa drugs or antibiotics should be 
given in addition to ACTH whenever the danger of suppurative 
complications is threatening. 

Treatment with ACTH or Cortisone may also alter the surgical 
aspects of the disease. When we consider that the mortality rate in 
emergency Operations is 50 7r and in properly selected cases only 9 % 
(Bargen), attempts are justified to overcome emergency situations by 



43 



4 Viichow Society, Vol. 12 (1953) 



means of endocrine thcrapy and to postpone surgery until the patient's 
condition is under reasonablc control. 

The foregoing discussion did not conceal my somewhat rcserved 
attitude with respect to the ultimate fate of patients suffering from 
this dreadful disease. There is, however, no doubt that the chances 
for recovery are considerably greater today than 10 years ago. New 
discoveries in the field of metaboHsm, drug therapy and endocrine 
control have been applied to the treatment of ulcerative Colitis and, 
in combination with psychotherapy, have resulted in an entirely new 
pattem of medical management of the disease. The prospect of 
reducing the need for surgery has increased considerably, and if the 
surgeon is called upon to step in, the chances are today that he will 
take over many more good than bad surgical risks. 



44 



SURGICAL ASPECTS OF ULCERATIVE COLITIS 

Helml'th Nathan 

The ways of trcating a disease of unknown etiology cannot be 
but solely empiric. Often the procedures will be palliative only. Among 
the etiologic factors which are assumed to play a role in the develop- 
ment of ulcerative Colitis are infection, nutritional deficiency, allergy 
and psychosomatic reactions. Unfortunately, one rarely eures the 
existing disease by eliminating one or the other of these factors. Ul- 
cerative Colitis is a dreadful disease; it occurs frequently in young 
people who are in the prime of their life and above average intelli- 
gence. Almy states that the condition is apt to produce inflammations 
as huge as any observed in clinical medicine. Bacon compares it with 
a third degree burn of the colon, with severe secondary infection and 
coating of the mucosa with fecal purulent poultice. Ulcerative Colitis 
Starts usually in the rectum, proceeds to the sigmoid and ultimately 
involves the upper part of the colon and cecum. In a number of 
cases the process will pass the barrier of the ileocecal valve, and then 
we face the even more frightening disease of ileocohtis. In a smaller 
percentage of cases the disease Starts off in the proximal part of the 
Colon, and recently a number of cases have been reported where the 
colon was involved only secondarily as a result of an extending regional 
ileitis. I have seen a bov of 4 vears who was afflicted with the disease, 
and there are reports on ulcerative Colitis in the newborn. The disease 
is rarely seen in the aged. 

Obscure in its etiology, uncertain in its prognosis, fluctuant in 
its remissions, the condition poses a difficult problem from the thera- 
peutic viewpoint. It can be controlled without surgery in about 60 to 
S5^/c, but as Jordan and Kiefer have stated, a eure is possible only 



45 



Acute exacerbation 
Multiple remissions 
Uncontrolled, continuous diarrhca 
UncontroUcd hcmorrhage 

(chronic, acute) 
Perforation (chronic, acute) 
Perirectal abscess 



Indications for Surgery 

Anorectal fistulae 

Obstruction (chronic, acute) 

Pseudopolyposis 

Malignant degeneration 

Arthritis 

Gangrenous pyodermy 

Rigid-pipelike rectum and sigmoid 



by surgical removal of the colon. We have heard Dr. Krieger's pre- 
sentation of current mcdical aspects. The optimism which followed 
the introduction of ACTH and Cortisone has received severe setbacks. 
More and more cases of ACTH-treated patients are reported in whom 
Short improvement was followed by severe bleeding and Perforation. 
Such occurrences are especialh dangerous because they are often 
masked by the apparent well-being of the patient. Cooperation of 
family physician and surgeon is indispensable not only before but also 
after surgical intervention. Once it has been decided to resort to sur- 
gery, repair and maintenance of electrolyte and fluid balance has to 
be attended to, antibiotic therapy must be initiated and proper psycho- 
logic care must be provided. Dr. Crohns opinion regarding psycho- 
therapy is outdated; he niaintained that a psychiatrist on the bedside 
of such a seriously ill patient is a wastage of time, energy, good thought 
and money. Not only the psychiatrist, but also the physician and the 
surgeon should take time out to give the patient mental comfort and 
confidence. 



Surgical treatment must be fluctuant, both in its indication and 
in its technical procedures. Without going into details I shall first give 
you a brief outline of the indications for surgery as I see them from 
my relatively conservative point of view. 

Early surgery seems to be indicated in all cases of the f ulminating 
type ; their mortality is very high with any kind of therapy, even with 
surgery. Catell and Cave had a mortality ranging from 53 to 75%. 
No wonder that Cave suggested recently an earher and more radical 
application of surgery in these and other forms of ulcerative Colitis. 



46 



Surgical Procedures 



Indirect 
Vagotomy 

subdiaphragmatic 

supradiaphragmatic 
Pelvic neurectomy 

sympathetic 

parasynipathetic 
Lumbodorsal sympathectoniy 



Direct 
Shortcircuiting 

ileostomy 

cecostomy 

ileosigmoidostomy 
Eliminating 

colectomy 

one-two-multiple stage 
partial-subtotal-total 

one + two team 



Howard Lilienthal performed surgery in ulcerative Colitis already 
in 1901 ; he used a multiple stage procedure with good results. If the 
mortality of ulcerative Colitis is still high, we have to blame that at 
least partly on an unduly conservative attitude towards the indication 
for surgery. In the series of cases shown on the chart the mortality 
is high in both the medically and surgically treated patients. But if 
we consider that onlv the most severe cases came to surger) and that 
total colectomies show even better results than the combination of 
all availablc medical methods, advocation of early surgery seems to be 
justified. Only in one group of cases is utmost conservatism indicated, 
that is, in young children. Their mortality is terrifically high. 

Operative procedures include 3 methods. The first, uses the in- 
direct approach and is aimed at eliminating the nervous Impulses 
and thereby changing the pattem of intestinal motility. Dennis, Torek 
and others advise vagotomy, either supra- or subdiaphragmatic. Since 
the vagus supplics only the right side of the colon, Hinton, Frykman 
and others have sugc^ested to remove the autonomous presacral and 
pelvic parasympathetic ganglia. Vagotomy as advocated by Dennis 
has not been accepted as an eflective method of treatment since it 
leads only to temporary improvement which takes place so often spon- 
taneously in the course of the disease. Hinton's procedure (exposure 
of the ganglia by incision of the peritoneum on the sacrum) involves 
some postoperative complications (temporary disturbances in voiding 
and ejaculation) and is not yet recommended for general use, although 
it certainly represents one of the most promising approaches to the 



47 



Problem. These rncthods, howcver, do not eliminate the potential 
development of Cancer which occurs tvvice as frequently in patients 
with ulcerative Colitis than in the average population and is often 
especially malignant. 

The second category of methods is designed to establish short 
circuits: Ileostomy, cecostomy and ileosigmoidostomy. Their aim is to 
put the diseased colon at rest. After ileostom), whether done as a 
double loop or closed and open end procedure, the mortality rate is 
18 to 21 7r. Dehydration, perforation, Peritonitis and severe bleeding 
from the colon are among the sequelae. Improvements are only tem- 
porary, if they occur at all, and the re-anastomosis with the sigmoid 
usually causes a flare-up of the disease. Under these circumstances, 
the rule has been generally accepted: Once an ileostomy, always a 
colectomy. 

Paradox as it might appcar, patients in whom ileostomy failed 
are doing well on colectomy. This Operation can be done in one, two 
or multiple stages, as partial, subtotal or total colectomy. In the one 
stage Performance of subtotal colectomy, combined with immediate 
abdcmino-perineal resection, two surgical teams may take part, one 
doing the perineal and the other the abdominal Operation. The most 
modern and most successful Operation is the one-stage immediate 
ileostomy with subtotal colectomy, followed within one to three months 
by the abdomino-perineal resection. Bacon, Gavon and Miller and 
his associates have introduced this new courageous approach into ihc 
surgery of ulcerative Colitis. Figure 1 shows the amount of colon 
removed during one of these Operations (details of the technique are 
given). The patients recover amazingly fast and may return in about 
two months to their occupational and social activities. This adjust- 
ment has lost much of its hardships thanks to the Rutzen bag which 
can bc worn almost unnoticed under any kind of clothing (ladies' 
evening dress). The question may be asked whether abdominal ileo- 
stomy could not be circumvented altogether? Ravitch has suggested 
an ano-ileostomy as an alternative procedure in the treatment of Poly- 
posis but not in ulcerative Colitis. Recently organized ileostomy clubs 
ofTer unique opportunities for patients with ulcerative Colitis to join 
in their efforts of adjustmcnt, to discuss their problems of rehabili- 



48 




Fig. 1. Terminal Ileum and Colon to be removed in one stagc. 

tation, to give and receive encouragement in battling against technical 
difficulties and mental strain caused bv the dreadful disease. 

I want to show you briefly two of our patients who were operated 
on recently. Both have total colectomies; one had a perforation, the 
other one a prolonged bleeding of such severity that we could hardly 
pour blood in as fast as he was losing it. That they are both living 
happily and doing füll work now is sufficient proof for the fallacy of 
the old saying, "The patient is too sick to be operated on". Instead, 
we must have the courage to say, "He is too sick not to be operated on." 



49 



PSYCHIATRIC ASPECTS OF ULCERATIVE 

COLITIS 

Bernhard C. Meyer 

The attention of the psychiatrist to the problem of chronic 
ulcerative coHtis embraces three phases: 

1. Psychologie factors playing an etiologic or contributan' role in 
the genesis of the illness. 

2. Psychologie reactions to the illness. 

3. Psychiatric manifestations associated with improvement or eure 
of the disease. 

Of these three aspects of the problem the second, the psychic 
reactions of the patient to the physical illness, is so patent as to tend 
to overshadow the other two. Psychiatric and psychologic investiga- 
tions, however, have shown that the pre-colitic personality of patients 
with chronic ulcerative Colitis tends toward a certain type, charac- 
terizable as narcissistic, passive, vulnerable, infantile, dependent and 
repressed. Equally typical is the denial of emotional conflict and a 
rather vigorous defense, occasionally assuming hostile or paranoid 
proportions, against attempted penetration of this denial. Acute onset 
of the colitic Syndrome often follows psychic trauma, especially the loss 
of a so-called "key person" from the life of the patient. Similarly, 
severe electrolyte disturbances in the ileostomy patient not infrequently 
occur after emotional disturbances, often of a seemingly minor degree. 
With the disease established the Colitis patient tends toward a regres- 
sive preoccupation with the condition and its manifestations, exhibit- 
ing an abandonment of the fastidiousness and nicety so characteristic 
of the pre-colitic personality to a degree reminiscent of the coprophilic 

50 



I 



behavior of severely regressed State hospital inmates. This finding is 
in keeping with other indications that the ulcerative Colitis patient is 
often but delicately defended against an underlying psychosis. Inju- 
dicious psychologic probing has not infrequently unfolded severely 
psychotic productions and behavior. This impression of an underlying 
psychotic pattern is confirmed in Rorschach and other psychologic 
studies. In not a few instances a reciprocal relation between psychosis 
and Colitis has been observed : the outbreak of a frank psychosis being 
accompanied by a disappearance of the colitic Syndrome. Such 
occurrences as well as the reverse suggest that the Colitis may serve a 
defensive purpose, protecting the individual against psychotic break- 
down. Somatic conditions as well as psychotic episodes, e.g. asthma, 
have also been known to "replace" the Colitis. In other instances Coli- 
tis and psychosis occur concomitantly. Psychiatric treatment encoura- 
ging the production of repressed and phantasy material is often hazar- 
dous and may lead to psychotic upheaval. Most observers agree that 
the most effective therapeutic Psychiatric tool is the establishment of 
a warm human relationship between doctor and patient, supplying to 
the latter a replica of the "lost" "key individual" in the person of the 
physician, whether Internist, surgeon or psychiatrist. 



51 



4* Virchow Society, Vol. 12 (1953) 



NEWER TECHNIQUES IN CINEPLASTIC 

AMPUTATIONS 

Ernst W. Bergmann 

Cineplastic procedures have made slow headway in this country, 
yet the field of application should grow considering the ever increasing 
number of industrial and traffic accidents. 

The principle of cinetization is to make use of certain muscles 
for purposes of activating an artificial hand or hook. 

The initiative in transforming an arm stump into something 
more useful was taken by the Italians, but their method of forming 
tendon loops at the stump end proved not very successful and has not 
many advocates. 

Sauerbruch's muscle canal Operation is far more satisfactory. It 
uses a skin tube which is fashioned from a pedicle skin Aap by sewing it 
inside out. This tube is passed through a tunnel in the muscle belly 
and it moves with the contracting muscle. It is this movement which 
is utiHzed to activate an artificial hand. 

The operative technique as originally developed by Sauerbruch, 
has been modified by Lebsche und by Spitder as follows: 

1. Canalization of the forearm muscles has more or less been given 
up even in stumps having the necessary length as stipulated in 
previous pap>ers. 

2. As a rule, the canalizadon is applied to the biceps alone. The idea 
of a double motor, that is the addition of a triceps tunnel for anta- 
gonistic action has been given up, leaving this action to a spring 
in the terminal device. 



52 



3. The skin tube is made considerably wider. 

4. The biceps tendon is severed from its distal attachment, so that it 
no longer flexcs the elbow, a function which is left to the brachialis 
alone. 

5. In Short arm stumps the method can be very successfully applied 
to the pectoralis muscle. This is in obvious contrast to what Sauer- 
bruch and later Nissen and myself have said on sundry occasions. 
Lebsche's pectoralis tunnel has proven a most valuable procedure. 
( Demonstration of two patients with biceps tunnels. ) 



53 



PULMONARY SARCOIDOSIS 
F. C. Burgheim 

Since roentgen examinations of the ehest have beeome a routine 
offiee proeedure, I should like to demonstrate a ease whieh might 
easily be mistaken for tubereulosis or malignant tumor, the two con- 
ditions doctors are mostly concemed with. I also want to show this 
case of pulmonary sarcoidosis or Boeck's sarcoid in order to impress 
on you the most characteristic pattem of this disease. 

Slide No. 1. This is the so-called sarcoid type (Garland) of 
bilateral, symmetrical enlargement of the peribronchial lymph nodes, 
while the paratracheal lymph nodes are involved only on the right 
side. Coarse lymphatic markings radiating toward the periphery and 
several small areas of pulmonary infiltration are also noted. - The 
patient, a young, healthy-looking man, active in all kinds of sports, 
was much surprised when he was rejected by the Army in 1942 after 
a routine ehest film had been taken. I saw him a few days later in a 
very depressed mood, as he had been told that he was suffering from 
advanced tubereulosis. 

However, this initial diagnosis was wrong, based solely on an 
erroneous interpretation of the X-ray film. The "sarcoid type" of pul- 
monary lymphadenopathy, the excellent general condition of the pa- 
tient who had no cough, no dyspnoe and no fever, his negative Sputum 
and negative tuberculin test, a normal blood Sedimentation rate and, 
finally, the clinical course disclosed the identity of the disease: sar- 
coidosis. 

Slide No. 2: Seven years later - I omit the films taken in the 
meantime -, without any treatment or change in the patient's daily 
habits, we find a marked improvement indicating that the condition 



had been stationary for many years. This is also a characteristic 
finding in this disease. Sputum and other tests remained negative. 

Slide No. 3: This film, taken more than 10 years since the disease 
was discovered, reveals further improvement: the coarse striations 
and the enlarged paratracheal lymph nodes on the right side have 
disappeared. 

Slide No. 4: The last film was made only /2 year later. The pa- 
tient had just been treated at a hospital with a total of 550 mg. Corti- 
sone for an allergic j>enicillin reaction. It is remarkable that this 
relatively small dose of Cortisone has produced an immediate, though 
slight Clearing of the lesions. Such efTects of Cortisone have been de- 
scribed in the literature following intensive treatment, and I believe 
that this also confirms our diagnosis. 

Time does not permit to go into details of this interesting disease, 
originally described as skin lesion. We know that it may occur in any 
part and tissue of the body and that its course may be as variable as 
its manifestations. Since this is not my first Observation of this kind 
I would hke to emphasize once more that the bilateral and symmetri- 
cal hilar lymphadenopathy in an apparently healty person is suggestive 
of pulmonary sarcoidosis. 



54 



55 



ACUTE MESENTERIC VASCULAR 
OCCLUSION FOLLOWING MUMPS 

Wolf Elkan 

Acute mesenteric vascular occlusion still remains one of the most 
serious surgical catastrophes with a mortality of 90-95 % according 
to recent comprehensive reviews of the literature. Ficarra in 1944 
collected 569 cases with 35 survivals, a mortality of 94%. McClena- 
han and Fisher in 1948 collected 616 cases with a mortality of 93 %, 
Whittaker and Pemberton at the Mayo Clinic in 1938 reported 
3 survivals in 60 cases, a total mortality rate of 95 % . The actual 
mortality may even be higher since not all cases are correctly diagnosed 
preoperatively, many patients come to the hospital in moribund con- 
dition and often no autopsy is performed. The reasons for this high 
mortality are twof old : First, the rare incidence of the condition which 
ranges between 0.02% and 0.05% of all hospital admissions. Se- 
condly the diagnosis is very difficult to make because Mesenteric Vas- 
cular occlusion has no typical clinical picture. The onset may be in- 
sidious, subacute or fulminating. The pre-operative diagnoses in most 
reported cases have been gastroenteritis, Cholecystitis, acute pancrea- 
titis, atypical pneumonia, lead poisoning, appendicitis, intestinal ob- 
struction, volvulus, paralytic ileus, renal colic, perforated ulcer, Car- 
cinoma divcrticulitis, etc. 

Since the picture is often uncertain, much time is spent with 
diagnostic procedures. Mortality rises with every hour that passes 
between onset of the disease and surgical Intervention. Death occurs 
both from shock due to the loss of blood volume caused by tremendous 
outpouring of blood into the intestinal lumen and peritoneum as well 
as from toxemia caused by gangrenous intestines. 

56 



Often Operation is refused by the surgeon on account of the 
patient's poor condition. This is definitely wrong inasmuch as failure 
to operate will lead to certain death while surgery gives the patient 
his only chance for survival. 

Many times, resection is not done because too much of the 
intestine appears to be involved. This is equally wrong since a number 
of cases have been reported where almost all of the small intestines 
had been resected leaving as little as 17 cm., 20 cm., and 45 cm. of 
ileum and one case where even the ascending and one half of the 
transverse colon had to be resected with subsequent survival of the 
patient. Massive involvement, therefore, is no contraindication for 
resection since, here again, failure to resect will lead to the death of 
the patient. 

Symptom atology: The onset is frequently insidious with vague 
abdominal pains, indigestion, belching and vomiting for one to seven 
days; then the temperature rises up to about 101, the pulse becomes 
very rapid and the WBC generally is found between 20 and 30,000 
with a high difTerential count. 

Abdominal distention sets in but true rigidity is often absent. 
A typical Symptom is very severe pain, out of all proportion to the 
physical findings. Blood tests show hemo-concentration ; X-rays fre- 
quently show dilated loops which extend down to the splenic flexure 
suggesting intestinal obstruction. Barium, however, if given by enema 
passes freely beyond this point, a diagnostic sign which has been 
described by Harrington. The overall clinical picture has been 
described as a composite of internal hemorrhage and intestinal ob- 
struction. 

The etiology of this condition may be classified as follows: 

1. Mechanical causes: a) adhesions, b) volvulus, c) Strangulation, 
d) pressure of adjacent tumors and e) portal stasis. 

2. Traumatic causes: a) trauma of the abdomen and b) tearing of 
the mesentery. 

3. Blood dyscrasias: a) polycythemia vera and b) splenic anemia. 

4. Infections: a) appendicitis, b) pelvic inflammation, c) Chole- 
cystitis, d) f>eritonitis, e) diverticulitis and f) thrombophlebitis. 



57 



5. Cardiac causes (for the arterial type): a) auricular fibrillation 
and b) rheumatic heart disease. 

6. Miscellaneous causes: a) periarteritis nodosa, b) mesenteric 
thrombosis following lumbar sympathectomy or procaine block 
of the lumbar chain (Laufmann and Scheinberg, Bauer) and 
c) obesity. 

7. Unknown causes: In a very large number of cases, thrombosis 
of the mesenteric vein must come under the etiologic heading of 
primary venous thrombosis or "Mesenteric vascular thrombosis 
without apparent cause". Since it seems unlikely that a condition 
of such gravity should develop by itself and for no reason whatso- 
ever, it must be assumed that in those cases a causative factor 
does actually exist but has not become apparent to the chnician. 
Such cases ränge between 35 and 40 % in recent computations 
of the hterature. 

In the following case report, a new etiology is described which 
I have not found anywhere in the international Hterature up to the 
present date. It is a case of acute surperior mesenteric vein thrombosis 
following acute pancreatitis after mumps. 

The patient, a 32 year old male with a non-contributory past medical history 
suffered from an attack of mumps, on May 9, 51. He received two injections of 
immune serum globulin on May 9 and 11, and 5 mg. of diethylstill-bestrol daily 
to prevent Orchitis, and improved. Two weeks later he suflfered from pain in the 
left hypochondriurn and back, indigestion, belching and feeling of fullness; he 
passed soapsy stools. His spermatic cords were tender to the touch. The diagnosis 
of pancreatitis following mumps was made. He was treated with bed rest and a 
fat free diet. His pain and temperature increased and he was hospitalized on 
May 31, 51. His weight at that time was 195 Ibs., temp. 100.2, pulse 90, respiration 
20, BP 125/80. He had slight tenderness in the LUQ. RBC 5/2 million hemo- 
globin 110 % indicating hemo-concentration; WEG 16,100, poly 83 %, Stab forms 
12%, lymphs 3%, monos 2%. The urine was essentially negative. He was 
treated with intravenous fluids and penicillin and improved. Two days later he 
suddenly coUapsed. His temperature rose to 103.4, pulse to 136. He assumed an 
ashen gray color and was covered with cold Perspiration. His BP feil to 90/60 
while his abdomen became distended and no peristalsis could be heard. 

In spite of his precarious condition, immediate surgery was decided upon, 
on the assumption that a perforative hemorrhagic pancreatitis had occurred. On 
opening the abdomen about 2000 cm^ of dark sanguinous fluid was aspirated. In 
the LUQ a convolut of distended gangrenous intestine was found beginning about 
30 cm. below the ligament Treitz and extending for about 180 cm. The entire 

58 



involved intestine was rapidly rese( tt-d and a side to sidc anastaniosis was done, 
with about 20 cm"'* of overlap to safcguard against advancing marginal thrombosis. 
During the Operation the patient wrnt into derp sho( k and became mori- 
bund and received last rites. About V:« of the Operation was carricd out without 
anesthesia, carrying the patient on oxygcn and blood transfusions only. The post- 
operative coursc was cxtremely stormy with a temperature rise to 106, abscnt 
pulse and BP, and heart rate of 180. The patient was treated with blood trans- 
fusions, parental fluids, vitamins and anticoagulants; using heparin intravcnously 
for the first 48 hrs., and following with dicumarol thereafter. He received anti- 
biotics and Cortisone to overconie what appeared to be adrenal exhaustion. After 
the first critical days the patient had an uneventful recovery, except for what 
appeared to be a thrombotic episode on the 10»^ postoperative day. This, how- 
ever, was overcome with anticoagulants. It was found at this point that the com- 
bination of heparin and dicumarol will in rare instances be antagonistic instead 
of symbiotic and dicumarol alone was given from then on with good rcsults. 

The patient was allowed out of bed on the 15'^ postoperative day and dis- 
charged from the hospital on the 21**' postoperative day in excellent condition. He 
has been well now for two years. 

It is suggestcd that the entity of mesenteric vascular occlusion be 
kept in mind in all cases of unexplained intra-abdominal conditions 
and that surgical intervention be not delaycd by protracted diagnostic 
procedures. 

This case as well as othcr cases in the hterature prove that surgery 
must be done regardless of the apparent hopelcssness of the patient's 
condition since failure to operate will Icad to certain death. Intestinal 
resection must be done as widely as possible regardless of the extent 
of involvement. 



59 



TREATMENT OF EXCESSIVE SMOKING 

BY HY PN OS IS 

Edith Klemperer 

Patient started smoking at 13 years and immediately smoked 
2-3 packages daily, but took only a few puffs with each cigarette. 
A few months later, he smoked all cigarettes to the end. He is now 
44 years old, is bored with his occupation (pressing clothes) and 
abets smoking. In 1949, diabetes, claudicatio intermittens, and a 
questionable Buerger's disease were diagnosed. Pulse of dorsalis pedis 
and tibialis were not palpable. After Walking one or two blocks he 
had to stop because of pains in calves. He had no relief f rom his com- 
plaints after he had received 30-40 injections, and was told to stop 
smoking. However, "I just have to smoke" was his reply. Since a 
stomach ulcer wa.s detected 4 months ago, he keeps to a diet and 
takes pills to combat the pain. 

He was first seen on March 4, a Wednesday and was told that 
hypnoanalysis would be preferablc to hypnosis in his particular case. 
All analytic endeavors failed, however, because of the patient's Op- 
position. Hypnosis could be easily induced. He received the conven- 
tional soothing suggestions, some of negative nature (that he would 
not want to smoke) some of pasitive (that he would feel fine without 
smoking). Scheduled for another session on Saturday, March 7, he 
phoned saying that he had no desire any longer to smoke and would 
not return for treatment. Sunday he took up smoking again, under 
the following circumstances. Although he had no urge to smoke, not 
even in the smoker's lounge, his girl friend happened to ask him (in 
the Cafeteria) to buy her a pack of cigarettes and to light one for her. 
When he did so, she refused to smoke it. Left with the lighted cigarette, 



60 



he didn't want to waste it and did smoke it. This started him on the 
old road. 

He gave me this story on March 16, when he returned to see me. 
His stomach was fine and he no longer needed pills. He said that his 
legs were better. Hc was again hypnotized and got some additional 
suggestions. This time he stayed away from smoking for only two days. 

He came again to see me on April 7. His stomach did not cause 
any discomfort, the condition of his legs was unchanged. When asked 
what kind of taste he disliked most, he named camphorated oil and 
"tasty" gasoline. In hypnosis, the suggestions were made that a ciga- 
rette would burn his fingers and that its taste would be like that of 
camphorated oil and "tasty'' gasoline. When he returned on April 16, 
he reported not to havr smoked thus far and to feel well. "There is a 
wonderful change with my stomach, I have no pains, I don't want 
to smoke". The same suggestions as made in the preceding hypnosis 
were repeated at this session. 

Patient abstained from smoking for 1 7 days, until April 24. On 
this day, while he was eating in a restaurant, his bottom plate broke. 
He feit very upset and embarrassed and took to smoking again. But 
he threw the cigarette away after a few pufTs because he did not 
"get any pleasure out of it". W^hen he was seen on April 29, he had 
smoked only 2 packages and 6 cigarettes in these 5 days, about as 
manv as he used to smoke formerlv in one dav. He was able to eat 
spicy food, his appetite had improved, he was gaining weight. Follow- 
ing the renewed treatment by hypnosis he surrendered cigarettes and 
matches and voiced his Intention to see his physician in order to ask 
him for injections. He was not heard from since. It may be assumed 
that his habit was bioken. It is of interest that there were no untoward 
signs of abstinence at any time. 



61 



CANCER OF THE LUNGS AND LOBECTOMY 

R. Lewin 

l'he incidence of malignant tumors of the lung has steadily in- 
creascd in recent years. A broad program is needed to combat ihis 
form of malignancy at every level of medical service. The practitioner 
can participate in this program elTectively and should make every 
effort to do so. A review of my own cases observed from an early 
stage through the critical phases of the disease may give you a reahstic 
picture of its common course and of the problems concerning early 
diagnosis and surgical inter\'ention. 

The diagnostic difficulties are in no way an obstacle which 
cannot be overcome, as I have shown on a previous occasion. This 
should again be demonstrated today by two case histories. In both 
patients the presence of a bronchogenic Carcinoma with abscess for- 
mation, as originally suggested by the X-ray appearance of the lesions, 
was not confirmed by the outcome. The lesions disappeared comple- 
tely with antibiotic therapy and turned out to be lung abscesses. 
Another point seems worth while mentioning. While every unex- 
plained pulmonary lesion in an adult patient should be looked upon 
as potentially malign, onc should never fail to include tuberculosis 
into the differential diagnostic considerations. This is illustrated by 
the following case of a 50 \ear old white male patient. He was ad- 
mitted to one of the hospitals for Cancer and allied diseases because 
a ehest film had disclosed the presence of lesions of potentially malig- 
nant character ^film). However, the pulmonary findings turned out 
to be of tuberculosis naturc. A ehest film taken 15 months later, while 
the patient was still under treatment, showed that most of the ab- 

62 



normal densities seen at the first film had undergone calcification 
conforming to the patterns of healing of pulmonary tuberculosis. 

I shall now discuss the history and films of a number of patients 
whom I saw durine the last few vears in mv office. 

The first and oldest patient, a man of 83 years, had a history 
of persistent coughing and hemoptoe. X-ray examination revealed a 
density in the lower lobe of the left lung. This proved to be a growing 
tumor. Local and general Symptoms were mild and there was not 
much suflering. Progressive heart failurc led to death. 

The second case concerns a man agcd 77 who for several years 
was suflering from hypertension, chronic bronchitis, and mild asth- 
matic manifestations. Frequently performed fluoroscopic examinations 
did not reveal anything suggestive of tumor. Then followed a short 
feverish sickness diagnosed as virus pneumonia. A large density in the 
left lung was found- with the characteristic appearance of a malignant 
process. The patients advanced age and the fixed hypertension ruled 
out any surgical Intervention. He was treated symptomatically and 
lived with relatively little discomfort for several months. 

The next case is that of a woman in her 60's who had been 
treated for lymphatic leucemia over a period of many years. She 
suddenly showed a density in her right lung. Papanicolou was nega- 
tive. Radioactive phosphorus, nitrogen mustard and X-ray radiation 
failed to have any beneficial results. Finally, bronchoscopic examina- 
tion revealed that the pulmonary' lesion was not of leucemic nature, 
but a bronchogenic Carcinoma. 

The next case was seen first when he had an acute coronar\' 
occlusion in 1948. He continued to have precordial pain on effort 
and had a second infarct in 1950. A few months later he underwent 
a successful gall bladder Operation. About a year ago he took sick 
with fever and persistent coughing. My diagnosis was virus pneu- 
monia. When the patient failed to improve, ehest X-rays were taken 
which showed a diffuse infiltration of the right lower lobe. By broncho- 
scopy (visualization and biops\ ) and examination of the pleural 
exsudate, this infiltration was established as a bronchogenic Carcinoma. 
Since surgery could not be considered because of the cardiac Status, 
X-ray treatment was initiated, but failed to prevent rapid deterioration. 



G3 



Under similar circumstances I lost 4 other patients with pul- 
monary mali.i^nancies because surgical treatment was precluded. 



M n ■JuMK.n» liß a ■ 




Fig. 1 



The last case of this group looked much more promising when 
I saw him first in September, 1952 and I trusted that my ardent 
efforts in early Cancer detection would be finally rewarded. This man 
was 57 years old and complaining about a distressing cough for some 
time. Like most of the patients reported on tonight, he was an excessive 
smoker and he attributed the coughing to this fact. On X-ray examina- 
tion ( Fig. 1 ) it became evident that he had a pulmonary tumor show- 
ing as a circumscribed oval shadow in the periphery of the right lower 
lebe. Lobectomy was performed. The anatomic diagnosis was squam- 
ous cell Carcinoma. There was good reason to hope that surgery at this 
early stage would result in a complete eure. But his well being was 
only of Short duration. Soon, the patient's condition worsened and the 
appearance of metastatic brain lesions once more turned our hopes 
into disappointment. Whether total pneumonectomy could have pre- 
vented this outcome is a ver\' important question. From recent dis- 
cussions of this problcm I have gained the impression that pneumon- 
ectomy must be considered the superior method of treatment. 



64 



When one's own efTorts in the management of malignant lung 
tumors bring nothing but failure and disappointment, one will readily 
understand why a campaign is being waged with the aim of improving 
early detection of lung Cancer. W e have to detect the disease in its 
\'ery early stage when the patient is still symptomless and feels not 
yet impelled to ask for medical advice on his own initiative. Periodical 
examinations of all persons over 40 or better over 30 years of age is 
the safest prophylactic measure. This sounds Utopie but could be done 
through a program of public education with teeth in it ! Such a pro- 
gram must alert patients and physicians alike. Periodic X-ray ex- 
amination of the ehest must become a matter of routine. Kxisting 
Cancer detection centers cannot do the Job alone. PLvery practitioner is 
needed for the realization of a program of this magnitude. Many more 
opportunities must be provided for Instruction in the recent methods 
of detection. Medical and clinical societies should participate in these 
efTorts. When everv doctor's office will function as a Cancer detection 
Center, it may well be that Cancer of the lung is controlled and cured 
some day. 



65 



MYOCARDIAL INFARCTION IN A 
24 YEAR OLD BOY 

Rudolf A. Stern 

This report concerns the case of a \ oung Iranian graduate Student 
who has been undcr my care since July 1948. The past history is not 
contributory except for the fact that he has been of asthenic habitus, 
got easily exhausted from his work and was advised to have regulär 
checkups. The last one, on March 31, 1952, did not reveal any ab- 
normal findings. 

On Ma\ 19, 1952, he phoned my office asking for an appoint- 
ment the same day because of unbearable headache of three davs 
duration. Whcn 1 saw him, hc looked extremely pale and shaky. His 
temperature was normal, and no signs of infection could be found. 
His pulse was 60, and regulär, his blood pressure 75/60. (Previous 
readings were reported as 120/70.) No cardiac murmurs were heard 
and no pulmonar\ rales. On fluoroscopy, the diaphragm moved 
freely and the lung fields were clear. The heart appeared small but 
of normal configuration. The aortic arch was normal, Holzknecht 
free. A ehest film revealed a drop heart but no pathology. The ECG 
showed regulär sinus rhythm, a rate of 60, and a conduction lime of 
0.18. QRS measured 0.05, showed low voltage in Lead 1, and in- 
version in all ehest leads. ST was slighdy depressed in CF 5, but 
normal in the Standard leads. T was also normal in the Standard 
leads, but negative in all ehest leads. The abdomen was soft and not 
tender. Urinalysis was normal. The white count was 13.000, the ESR 
16 mm/one hour. 

Although the electrocardiographic findings did not signify the 
66 



presence of an acute infarction*, I feit strongly they warranted my 
decision to treat this condition as an acute coronary. Only then, on 
intense questioning, the patient supplied additional data of the histo* , 
headache that had developed during the last three days and was 
left-sided (face and cranium), ehest pain radiating to the left Shoulder 
(it Started soon after he had lifted a very heavy intrument). 

I prescribed bed rest and phenobarbital. Four days later, the 
blood count was normal, while ESR had risen to 33 mm/one hour. 
ECG now showed the waxing and waving of T waves characteristic 
of myocardial infarction in its early stage. At strict bed rest the patient 
made a quick recovery. The pain subsided after a few days, the blood 
pressure retumed gradually to normal. The temperature remained 
always normal. On June 6th, ESR was 14, and 9 on June 20. An 
ECG taken on June 25*^ showed satisfactory stabilization : QRS as 
well as T had become upright in lead CF 4 and 5, while all waves 
were inverted in CF 2. 

Thereafter, the patient was allowed to increase his activities 
gradually. No signs or Symptoms of any recurrence were noticed, and 
on August 1, 1952 he started a six weeks vacation. When he retumed, 
he feit perfectly well. Since all findings were normal, he was allowed 
to resume his work, with the stipulation that he must strictly avoid 
any kind of strain and abstain from smoking (he used to smoke a 
pack a day prior to his illness) . He has been seen at monthly intervals 
and has remained free from any signs and Symptoms of pathology. As 
of today, he has completed his Ph. D. thesis and is working as a 
research assistant. 

I believe that the presumptive diagnosis of myocardial infarction 
was confirmed by the course of the disease. This is a rare illness in a 
youth of 24 years. However, Yater and coworkers (2) could report 
on 255 such cases (between 18 and 30 years old) who were observed 
in the armed Services during World War H. All these men had been 
subjected to extremely strenuous activities. 

* The absence of characteristic findings in the ECG during the evolution 
of myocardial infarction has also been reported by Katz (1). His patient wn« 
30 years old. 



i 



67 



5 Virchow Society, Vol. 12 (1953) 



I want to emphasize the following points: Acute coronary in older 
persons is occasionally masked by various Symptoms such as indiges- 
tion, severe tooth ache, headache etc. If younger persons are stricken, 
they have almost always typical angina and are in severe shock. The 
foregoing account demonstrates that even in young patients the 
characteristic clinical manifestations of acute coronary may be absent. 
Under such circumstances, the nature of the disease has to be suspected 
in Order to be diagnosed. 



REFERENCES 

1. Katz, L. N.: Electrocardiographic Interpretation, p. 
Philadelphia 1946. 

2. Yater, W. M., etc.: Amer. Heart J. 36, 334, 1948. 



84, Lea and Febiger, 



68 



BOVINE TUBERCULOSIS OF THE KIDNEY 

Alfred Zinner 

I would Hke to report the case of W. M., a 30 year old white 
male who consulted me because of an urologic condition of 3 years 
duration. The first abnormal sign he had noticed was heavy cloudiness 
of his urine. There was no increased frequency of urination and no 
burning Sensation. His physician referred him to a hospital for dia- 
gnostic work-up. Upon completion of all test procedures (cystoscopy, 
intravenous and retrograd pyelography) he was discharged with the 
diagnosis of chronic cystitis. The guinea pig test was negative. Three 
years later he was referred to me. 

He appeared well nourished and did not seem to be scriously ill. 
On examination there was no costo-lumbar tenderness, and no en- 
larged kidney was palpable. The prostate was enlarged and some hard 
but not tender nodules were present. The very cloudy urine contained 
albumen (H — |-), numerous W. B. C. and some R. B. C. Numerous 
tubercle bacilli could be demonstrated in the stained sediment. The 
intravenous pyelogram revealed excretion of diodrast on both sides 
at normal rate and good concentration. While the left pelvis and the 
left Ureter appeared normal, the calices of the right kidney were 
somewhat blunt and the right Ureter was dilated to the width of a 
finger and completely atonic in its entire length. 

I was afraid that there might be no eure anymore, considering 
the long duration of the tuberculous infection. On ureteral catheteri- 
zation, however, normal urine was obtained from the left kidney, 
whereas urine from the right kidney contained pus and Koch bazilli. 
On cystoscopy, the bladder capacity was found to be normal, there 
was no ulceration, and indigo-carmine was excreted on both sides at 



69 



normal rate and concentration. There seemed to be no doubt about 
the presence of surgical tuberculosis of one kidney; the absence of 
bladder Symptoms, however, and more so the negative guinea-pig test 
were puzzling. Then I learned that the man was a butcher and the 
diagnosis of bovine tuberculosis of the right kidney seemed probable. 
Consequently, nephrectomy was performed on January 5, 1945. 
The surface of the kidney was studded with numerous isolated and 
conglomerate tubercles. The upper and middle calyx showed only 
mild excavation. There was only slight caseous necrosis. The specimen 
was taken immediately to the laboratory and both guinea-pigs and 
rabbits were inoculated with fresh material (Dr. G. Schwartzmann).* 
The guinea-pigs remained healthy, but the rabbits developed an in- 

fection. 

To corroborate the diagnosis, a patch test with human tuberculin 
and an intracutaneous test with bovine tuberculin (1 : 10,000) was 
performed with the patient. The patch was negative, the bovine 
tuberculin produced a severe local reaction. 

During the 7 years foUowing the Operation the patient has been 
treated in various hospitals with streptomycin, PAS, and more re- 
cently with isoniacid. Although he looks very healthv, the urine still 
contains tubercle bacilli. 

There are 4 known types of tubercle bacilli: human, bovine, 
avian, and "cold-blooded". According to Topley and Wilson (13), 
only the first two types are found in the naturally occurring tuberculous 
infection of man. This is not correct. Loewenstein has published 3 
cases of kidney tuberculosis in which the organisms were identified 
as those of the avian strain. Lederer has contributed another such case. 
However, these are rare exceptions. 

Some remarks may be in order as to the methods of diflerentia- 
tion. Smith (12), Dorset (4), and Huserang (7) claim that bovine 
tubercle bacilli tend to remain short and plump, whereas those of the 
human type are slender. However, the majority of investigators do 
not believe that morphologic diflerences constitute a satisfactory dia- 
gnostic criterium. All agree that the growth of the human strain sur- 
passes that of the bovine typye on all media. For this reason the human 

* This is the first rcported dircct inoculation of kidney tissue. 



70 



type is designated as eugone, the bovine as dysgone. On media con- 
taining glycerol, the human bacilli show a thick, confluent growth, 
the bovine type grows poorly if at all. The human strain often pro- 
duces a pigment of yellow or orange color, the bovine type does not 
(Griffith and Stanley [6]). 

Koch himself held ( 1901 ) that bovine tubercle baciUi were virtu- 
ally non-pathogenic for man, but had to admit later ( 1908) that man 
might be infected. He maintained, however, that "bovine" infection 
would rarely lead to the development of a serious tuberculous disease. 
We now know better. Tuberculosis of the cervical glands in children 
is caused by bovine bacilli in 58-85 % of the cases below five years 
of age, and in nearly 50 % of those 5-14 years old. Primary abdominal 
tuberculosis is almost invariably due to the bovine type. As to genito- 
urinary tuberculosis, the bovine type has been found in 15 % of the 
cases (Gervais, 5), and in 33 % of the patients with renal tuberculosis 
(Band 1). 

There can be no doubt that tubercle bacilli of both the bovine 
and human type, if they are sufficiently virulent, may produce infec- 
tions in guinea-pigs as well as in rabbits. However, bovine bacilli of 
low virulence infect rabbits much more readily than the organisms of 
any other strain (Villemin). Smith (12) states that "tuberculous virus 
of bovine origin possesses an exalted virulence for rabbits". Conse- 
quently, the rabbit test is generally considered as a reliable aid in 
determining the type of tubercle bacilli found in human tuberculous 
disease. It has long been known that the organisms found in renal 
tuberculosis are characterized by their low virulence (15). This ex- 
plains why many cases of kidney tuberculosis verified at Operation or 
autopsy, have not been diagnosed by means of the guinea-pig test 
(2,3,9,14). 

In conclusion, it may be stated: 

1 . Renal tuberculosis can be diagnosed in 94 % of the cases f rom 
the urinary Sediment - {xjsitive findings on the stained ( Ziehl-Neelson ) 
smear (Hottinger, 8). 

2. A negative guinea-pig test is not conclusive. Inoculation of 
rabbits is required in order to confirm or rule out infection with bovine 
bacilli. 



71 



3. The use of antibiotics does not assure sterilization of the urinary 
tract or the eure of advanced kidney tuberculosis. Strictly unilaterad 
destructive (surgical) renal tuberculosis is best treated by nephrectomy. 
Postoperative treatment should include administration of PAS and 
streptomycin (Latimer et al., 10). 



REFERENCES 



1. 
2. 
3. 
4. 
5. 
6. 
7. 
8. 
9. 



Ind. Bull. 52. 



Band, D.: Edinb. med. J. 42, 162, 1935. 

Blatt: Z. Urol. 19, 321, 1925. 

Boeckel: Tuberculose renale. Chapelot, Paris 1912. 

Dorset, M.: Wash. Gov. Printing Office, 1904, Bureau Anim. 

Gervais: Le bacille au type bovine. Lille 1937. 

Grifßh and Stanley: Edinb. med. J. 39, 173, 1931. 

Huserang, A.: Tuberculose humaine. These, Paris 1940. 

Hottinger: Z. Krankh. Harn-Sexualorgane 8, 178, 1916. 

Hyman, A. and L. T. Mann: J. Amer. med. Ass. 76, 1012, 1921. 

10. Lattimer et al.: J. Urol. 67, 750, 1952. 

11. Legeu, J.D.: J. Urol. 17, 154, 1922. 
Smith, T.: J. exp. Med. 5, 451, 1898. 

Topley and Wilson: The principles of bacteriology. 2"^ ed. Arnold, London 
1936. 

Wildbolz, H.: Die Tuberkulose der Harnorgane. Handb. der Urologie, Bd. 4, 
1927. 
Pels'Leusden: Arch. klin. Chir. 95, 245, 1935. 



12 
13 

14 



15 



72 



SUPERVOLTAGE ROENTGEN THERAPY 

F. C. Burgheim 



Supervoltage roentgen therapy represents one of the recent ad- 
vances in the field of therapeutic radiology. The term "suj>ervoltage" 
should not suggest any relationship to a superman's machine with 
su{>erefTects. It simply conveys the fact that voltages above the con- 
ventional 200,000 limit are employed. It would be more precise to 
speak of radiation therapy with voltages above 200 Kv, as suggested 
some years ago in editorials of leading radiologic Journals. However, 
I shall continue in using the less cumbersome and generally preferred 
term "supervoltage" until a better one is proposed. 

What was the reason for building su{>ervoltage machines? Roent- 
gen therapy reached the highest peak in its short history when in the 
1920's Regaud and Coutard reported about their new method, with 
which they had successfully treated cases of advanced Cancer of the 
larynx. They were able to demonstrate that a much higher total dose 
could be given - without causing serious damage - when the Single 
dose which produced a skin erythema and had been the limiting factor 
heretofore was divided in several smaller, daily doses. This discovery 
led to an almost revolutionary development in radiation therapy. The 
skin and, consequently, deep-seated tumors could be subjected now 
to doses capable of killing tumor cells, doses no radiologist had ever 
dared to dream of . 

Once the divided-dose or protracted fractional method was est- 
ablished, further improvement in the treatment of radioresistant car- 
cinomas was expected from more fK>werful X-ray apparatus. It was 
hoped that their harder radiation would provide for greater penetra- 
tion and an increase of the depth dose, i.e. the dose measured at the 



73 



depth of the tumor (which is, of course, smaller than the dose im- 
pinging on the skin). It could also be expected that the potential 
specific effcct of a shorter wave length (between 1 and 2 million volts, 
i.e. in the ränge of radium) would imitate the favorable action of 
radium. 

Since the construction of roentgen apparatus with voltages above 
the conventional 200 Kv. was only a physical engineering problem, 
it could soon be carried out in this country. I had the privilege of 
working with onc of the first 1 million volt macliines ever built (at 
the Columbia-Presbyterian Medical Center). It was a big, inflexible 
apparatus, causing many inconveniences, headaches and frustrating 
delays in its use for Cancer therapy. Compared with it the new 2 mil- 
lion volt machine I am using now for the same purposes at the Hospital 
for Joint Diseases seems to be one of the miracles of our technical age : 
a flexible, adjustable apparatus that can be handled almost as easily 
as the smaller conventional units. 

On the basis of this experience I believe that supervoltage radia- 
tion is distinctly superior to that of 200 Kv. in the treatment of malig- 
nant disease. One of the advantages is the increase in depth dose. 
Although this increase is only moderate per field, in combination 
with the use of multiple portals it leads to a considerable gain. This 
is particularly valuable in the treatment of deep-seated lesions in 
obese patients or in situations which require the Irradiation of small 
areas with only one field available. Another advantage (that came 
rather unexpected and was somewhat puzzling) is the fact that we 
can apply a dose to the skin that is still larger than that permissible 
with 200 Kv. under strict Observation of the described Coutard prin- 
ciple. And a greater surf ace dose means a f urther increase in the dose 
that becomes eflfective in the neoplasm. Today, the explanation of 
this phenomenon is well known. Without going into physical details, 
I will say only this: the so-called back-scatter, i. e. the scattering of 
softer rays back toward the skin during the passage of the supervoltage 
rays through the tissues, is negligible in comparison with the back- 
scatter at 200 Kv. Furthermore, supervoltage rays have their greatest 
intensity at 3 mm. beneath the skin and not at the skin surface as 
with lower voltages. In view of theses different biologic actions we have 

74 



to look out for danger signals in other parts of the body such as 
ihe subcutancous tissues and mucous membranes. However, if we 
stricdy adhere to the principles laid down by Regaud and Coutard 
and administer each irradiation at a slow rate, no severe damage to 
any tissue will occur. I mention this because some radiologists make 
up their own modifications of the protracted fractional technique in 
Order to save time. This willful deviation from the established technical 
rules may bring injury and discomfort to the patient and will certainly 
be avoided by those who appreciate fuUy the fundamentals of the bio- 
logic process involved. 

I should like to report on the successful treatment of such radio- 
resistant tumors as Carcinoma of the bladder, lungs, esophagus and 
Uterus; none of them received additional therapy, especially not ra- 
dium treatment. Although tumor doses exceeding 6000 roentgen 
Units (i.e. the lethal dose for Cancer cells) were delivered in certain 
instances, the reactions of skin and mucous membranes were noticeably 
milder than those described by others. No subcutancous or muscular 
fibrosis was observed during the years following the irradiation. l'he 
patients stayed rather comfortable throughout the course of treat- 
ments. I venture the opinion that the slow, protracted application of 
small intensities and moderate daily doses causes only little damage 
to the vascular-connective tissues, so that the normal cells of the tumor 
bed do not lose what Ewing once called their "power of adaptation". 
The highly gratifying results obtained in our series of malignancies 
seem to confirm the correctness of our method. 

I must also State the important fact that, owing to the mentioned 
lack of back-scatter, we can now irradiate through fields that have 
been previously treated with the conventional 200 Kv. An increasing 
number of patients are being referred nowadays to institutions equip- 
ped with supervoltage machines because previously applied ordinary 
deep X-ray treatment did not result in complete sterilization of the 
tumor or could not prevent local recurrences. 

Another important point is that large areas can be irradiated. 
This simplifies the technical procedure and guarantees a more homo- 
geneous penetration not only into all portions of the tumor but also 
into the adjacent tissues and lymph nodes. This could never be 



75 



G Virchow Socii'ty. Vol. 12 (195:}) 



achieved by the niost skilful arrangement of multiple portals. Super- 
voltage Irradiation with only one large anterior and one posterior field 
is indicated, for instance, in Cancer of the uterus and prostate. When 
still larger fields have to be exposed - as in all thase desperate cases 
where tumor metastases have spread to almost every part of the body - 
irradiation of the whole body in one exposure ( teleroentgen therapy) 
may be of benefit. Such a treatment when given with supervohage 
machines requires only very short exposures, while it takes hours to 
achieve the same effect with 200 Kv. radiation. These spray irradia- 
tions with very small doses, applied daily, and combined with local 
treatment (small fields, higher doses) can be applied for many weeks 
and often lead to astonishing palliative results. It is certainly worth 
while trying this method. Detrimental efTects upon the blood frequently 
observed upon teleroentgen therapy with lower voltages, were absent 
or negligible in my patients who received supervoltage teleroentgen 
therapy. 

Time does not permit to discuss a number of other characteristic 
difTerences between supervoltage and conventional roentgen therapy. 
However, a most recent advance in this field cannot be omitted: the 
combination of supervoltage with rotation therapy. This new tech- 
nique makes it possible to deliver a homogeneous high dose to the 
tumor and, if necessary, to regional lymph nodes, while the skin and 
other tissues receive a considerably smaller dose. After precise measure- 
ments have been taken with a body contourometer and the neoplasm 
is properly localized, the patient is placed on a rotation platform in 
such a Position that the tumor forms the center of rotation. For pur- 
poses of adjusting the position to minute details, it is very helpful to 
employ a light beam corresponding to the central ray and to take films 
with the supervoltage machine while the patient is set up for the 
irradiation. This technique is recommended for the treatment of 
gynecologic tumors, Cancers of the rectum, bladder, stomach, eso- 
phagus, mediastinum, bronchial carcinomas, and tumors of the 
pharynx, brain, and spine. (Slides were shown illustrating the proce- 
dure in general and its application in individual cases.) 



76 



THE PHYSICAL ASPECTS OF RADIOACTIVE 

COBALT THERAPY 

LiM-iAN E. Jacobson 

This atomic age, with its creation of radioactive Clements woi th 
far more than gold, can rightfully be called the fulfilment of the 
alchemist's dream. 

Until recently, only comparatively small amounts of radioactive 
material were produced for peace time use. However, with the produc- 
tion of radioactive Cobalt 60, the picture has changcd. In each Cobalt 
Beam Therapy Machine the radioactivity of the metallic cobalt ex- 
ceeds all the medically used radium in the whole world. 

The principle of making atoms radioactive is simple. Small 
nuclear particles called neutrons are "shot" at the atoms of an dement. 
Here and there a neutron strikes the nucleus and is there incorporated 
to form an unstable atom which at some time in the future will break 
up, giving out radiations, in other words, it will be radioactive. 

The Cobalt used in the Cobalt Beam Therapy Machine at Monie- 
fiore Haspital was niade radioactive by placing thin discs or wafers of 
metallic Co59 in the path of slow neutrons in the nuclear reactor or 
atomic pile at Chalk Ri\ er, Canada. Some of the atoms of stable Co39 
capture a neutron, become heavier, and change into unstable Co60. 
These wafers are left in the atomic pile for about six months. The 
source of radiation consists of seventeen thin discs placed one on top 
of another in an air tight steel Container. The composite forms a 
cylinder like a pill box, one inch in diameter and one half inch thick. 

In Order to protect personnel, the cobalt is placed in a lead in steel 
drum about two feet in diameter and four feet high. The cobalt in 



77 



this form is used in the same manncr as a supervoltage X-ray tube. 
Supervoltagc refers to voltages above 2,000,000. 



»ifflSSC 




Fig. 1 



The cobalt is housed in the center of the Container shown in 
Figure 1 . The head weighs 4000 pounds but can easilv be positioned 
by a push of the control buttons, which causes it to ride up or down 
or to pivot around the axis, rotating from the vertical to ten degrees 
above the horizontal. The mechanism is finely controUed despite its 
weight. 



78 



Hoiiow coi|^Hi>o«r 



UCHT SOUICf SWElOtNC 




DOM! 



'■*- HIAO CHCOMI TIMM 



••- SOUICI HOUSINO 



MIMARY DIArNtACM 



urra HOUSINO 



VARIAUf TREATMINI 
Ot^TANCf CONTKOl \ 

^1 




- lOWII HOUSINO 

ADJUSTAIlf OIAPHIAOM — 
ONf ONIT ASSiMtlT O» 
OfPOSING «lOCKS SHOWN 



^^AffRTUIE CONTIOl HANOliS 
-SHOWN fO* OUT Of rOSiTION 



IXAPNtAOM »OTTOM COVft 



Fig. 2 



Figure 2 shows the cross section of the drum. In front of the 
source is a hollow cone containing mercury which absorbs the radiation 
when the machinc is not in use. The mercury is pumped out by remote 
control from the control room when a patient is to be treated. If the 
power should fail or the outsidc door be opened, the mercury runs 
back into the cone by gravity, so that the machine falls safe. The size 
of the field is varied by moving the lead blocks which act as a dia- 
phragm. 



79 



The room in which the Cobalt Beam Therapy Machinc was 
placed, see Figure 3, is well suited for this purpose. The outside wall 
for four and a half feet is below ground level and faces a garden which 
is not used. The beam is directed toward this wall or the floor, which 
is direcdy on the ground. Wherc the direct beam might strike it, the 
outside wall was built up to a thickness of three feet of concrete on the 
inside. This is sufficient to attenuate the direct beam to below the 
tolerance levels of 6.25 mr/hr. All the other walls were filled in to 
a thickness of twelve inches, which is sufficient to reduce the scattered 
radiation in all directions below the tolerance level. The ceiling was 
found by a boring to be eighteen inches thick with eleven inches of 
concrete. Nothing was added. 

Floor Plan of Cobalt and Adjolning Rooms 

Garden 



Window 



100 cm 




Hall 



7 In Steel SMIng Door 



Fig. 3 



The Observation window from the control room to the therapy 
room is very interesting in that it is made of a special lead oxide glass, 
whose index of refraction is higher than that of any other glass hereto- 
fore made, so that even through an eight by eight inch window almost 



80 



the entire treatment room is visible. The window is two inches thick 
and gives the protection of one inch of lead. 

A Steel sliding door permits entrance from the hall to the Cobalt 
room. 

Under the most adverse operating conditions, after very careful 
measurements, the strav radiation was found to be well below the 
permissible amount in all places except through the steel door. This 
has been remedied by the construction of a barrier wall perpendicular 
to the wall containg the door, as can be seen in Figure 3. 

mr/hr at Wall in Control Room, Beam Vertical 



200^ 



^ I50V l 



% lOO 



0.05 



\ 



50 




50 100 150 200 250 
DIstance along Floor, Cm. 



Fig. 4 



The stray radiation measurements in the control room can best 
be shown by lines drawn through points where the stray radiation as 
measured with a survey meter is the same. These lines are called 
isostrays and are shown in Figure 4, when the beam is directed verti- 
cally düwnward. The stray radiation at ehest level nexi to the wall of 
the control room is .2 mr/hr., at foot level .5 mr/hr. When the beam is 
directed horizontally, as in Figure 5, the stray radiation is less, about 
.05 mr/hr. were the technician sits. 

The personnel operating the Cobalt unit have been monitored 
continuously by film badges and pocket dosimeters. The pocket dosi- 
meters are read at the beginning and at the end of the day and in- 
dicate that about 1 mr is received. This is approximately the natural 
leakage of the Instrument. In a two-week period the film badges have 



81 



received less than a measurabJe amount which is less than 20 mr. So 
the Operation of a Cobalt unit is as safe as that of a well protected 
X-rav machine. 



mr/hr at Wall of Control Room^ Beam Horizontal 



250 

200 

-o 150 

I 



i 



too 

50 





50 100 150 200 250 
Distance along Floor, Cm. 



Fig. 5 



Cobalt has distinct advantages over conventional X-rays in the 
200 to 400 kv. ränge. Cobalt gives off gamma rays which are more 
penetrating than those of radium and equivaient in penetration to 
X-ravs from a 3 MEV. X-rav machine. 

In comparing Cobalt and 400 kv. radiation, one finds that for 
400 kv., thirty-nine percent of the surface dose reaches a depth of 
10 cm. foi a 10 X 10 cm. field, and for cobalt radiation fifty-six per- 
cent. If one wanted to give a dose of 100 r to a tumor at that depth 
256 r of 400 kv. X-rays would have to be given to the skin but only 
179 r of Co60 radiation. Thus, for equal doses to the tumor, the skin 
and underlying tissues are spared with Co60 radiation. If the tumor 
is treated from several ports, the skin effect with Cobalt ceases to be 
the limiting factor as it has been with conventional X-rays. 

When the tumor receives the same dose with conventional radiat- 
ion as with Cobalt, the underlying healthy tissue receives a much 
greater dose, and therefore the systemic reaction is greater. Figures 6 
and 7 illustrate this point. If the tumor receives 5000 r with Cobalt, 
the skin at the ports of entry receives 4000 r and most of the under- 



82 



DISTRIBUTION OF D0SA6E WITH 200 KV 
hvl 1.25mm Cu, 50cm T.S.D., THREE 7X15 FIELDS 

Ca of Lung, Postoperative 

Posteriof 

rsoor 




7500r 



rsoor 
Anterior Fig. 6 



DISTRIBUTION OF DOS ACE WITH Co 60 
80cm S.S.D. THREE 7X13 FIELDS 

Ca of Lung, Postoperative 



Posterior 




Anterior Fig. 7 




Fig. 8 



hing tissue 3500 r. Whilc with 200 kv., the skin and a large portion 
of the underlying tissues would recei\e 6500 to 7500 r. This dose is 
bcvond tolerance and therefore, it is impossible to deliver a dose of 
5000 r to this tumor from three ports with 200 kv. X-rays. Large doses 
not possible heretofore havc been given to some patients with very 
little radiation sickness. 

There is a great deal more scatter with conventional X-rays than 
with Cobalt or supervoltage, which increases the volume of tissue 
irradiated with conventional X-ray. 

Even when equal doses are gi\'en to the skin, the efTect on the 
skin is far less with Cobalt than with conventional X-rays. Only mild 
erythemas and bronzing were obtained with large fields and doses as 
high as 5500 r to 6000 r at 4 mm. below the upper surface of the skin 
where the maximum is received with our set-up, and doses of 4500 to 
5000 r to the skin. Of course, one may question whether or not some 
difTerential action appears at a depth between conventional and super- 



84 



voltage radiation. This is still a moot question which necds further 
investigation. 

Cobalt radiation penetrates bone almost as easily as soft tissue, 
whereas conventional X-rays arc absorbed more by bone. Therefore, 
Cobalt can be used to treat a tumor underlying normal bone with less 
efTect to bone than with regulär X-rays. 




'■ S^j'T!''^'! 



Fig. 9 



The Cobalt Beam Therapy Machine and the roc^m protection for 
it are more expensive than a conventional X-ray installation, but 
considerably less expensive than supervoltage equipment and housing. 



85 




Fig. 10 



One must takc into account the decay of Cobalt 60. In five years 
half of it disintegrates and therefore, its activity is reduced to half of 
its original valuc. Whcn the times of treatment become too long, the 
existing Cobalt source can be exchanged for one of high specific 
activity. Since one pays for the r Output of a source, the cost of the new 
one is the difTerence between its price and that allowed for the activity 
of the old one. The old source is placed back into the pile, reactivated, 
and used over again. Whether this replacement is more expensive than 
the replacement of supervoltage X-ray tubes remains to be seen. 

For the radiation to be most efTective and do the least damage to 
healthy tissue, the rays must bc so directed that they always strike the 
tumor from several ports of entry. A great deal of attention is given 
to the exact location of the tumor within the patient. After the tumor 
has been located on the X-ray film or by fluoroscopic examination, the 
following procedure occurs in all head, neck, and ehest lesions which 
can be treated in the erect position. A light plaster of Paris cast is made 
of the portion of the body containing the lesion. Special lead markers 



86 



are placed on the cast anteriorly, posteriorly, and laterally. The patient 
is again placed in the cast and X-rayed in the same position as he is 
to be treated. An AP and a lateral film are taken. On thcse films the 
radiologist marks the lesion that he wants treated. See Figure 8. From 
the Identification of the markers on the cast with the correction for 
distortion, the physicist locates two pcrpendicular axes through the 
Center of the lesion as is seen in Figure 9. 




Fig. 11 



The contour of the cross section through the center of the lesion 
of the body with the cast is drawn on tracing paper. By applying 
isodose curves from various angles, he finds the most efficient way to 



87 



get a uniform radiation field for the lesion, with a minimum of damage 
to important structures such as eyes, and spinal cord. The centers of the 
ports of entry and exit are then marked on the cast. Each tiine the 
patient is treated, he wears the cast, and the machine is so positioned 
that the lucite cone fits into the center of the port of entry and the 
back pointer fits into the center of the exit port, as is seen in Figure 10. 
This means that the beam always is angled exactly in the same direct- 
ion. By using the Cobalt source as a diagnostic X-ray tube, wc have 
devised a way of taking films to verify that the tumor is being irradiated 

as planned. 

To get a minimum skin effect Cobalt can be used with a rotating 
platform as shown in Figure 1 1 . Rotation is used where the lesion is 
located more or less in the central axis of the patient. The patient is 
so positioned that the center of the tumor is at the center of rotation. 
Sometinies instead of having a complete revolution, the palient is 
moved back and forth through a sector of an arc. 

As a physicist, I dare not discuss results. However, this I can say, 
that if thcre is such a thing as a cancercidal dose, in most cases it can 
be delivered to any part of the bod\ without undue skin eflects, normal 
tissuc efTects, or radiation sickness. 

Excellent radiotherapy can be given without Cobalt or super- 
voltage. However, both of these, when used judiciously, are very good 
tools with which to do a better Job. 

Lillian E. Jacobson, Radiation Physicist 
Montefiore Hospital 
210th Street and Gun Hill Road 
New York 67, N. Y. 



88 



THE DIAGNOSTIC AND THERAPEUTIC USES 
OF RADIOACTIVE lODINE 

Martin Perlmutter 

Radioactive lodine - P-*^ - is useful clinically becausc of its 
following properties: 

1 . It is so powerful that therapeutic doses are exceedingly dilute, 
in fact so dilute that the Solutions are odorless, tastless, and will not 
cause reactions in patients who are unable to take Lugols Solution. 

2. Practicallv all of the iodide is either retained bv the thvroid 

' 4 4 

gland or excreted in the urine. 

3. The beta rays which destroy cells can penetrate only 2 mm. 
deep; as a result only the thyroid gland can be damaged. 

4. The gamma rays which do not destroy cells, penetrate into far 
more distant tissues and are useful for detection of thyroid tissue. 

5. The half-life of V''^ is eight days - short enough to prevent 
damage through Irradiation, and long enough to preserve the isotope's 
potency during its transport through the body. 

Application of V'-^^ for diagnostic purposes permits: 

1 . to assay the avidity of the th) roid gland for iodine. This test of 
thyroid function is not reliable when iodides (or various other drugs) 
have been administered prior to the Performance of the test. 

2. to make the diagnosis of thyroiditis and thyrotoxicosis factitia. 

3. to localize thyroid tissue even at sites remote from the neck. 

4. to detect functioning metastases of Cancer of the thyroid. 

5. to diflerentiate benign from potentially malignant isolated 
nudules. 



89 



. . r. utsftfw yvrr^-ijvf: thvT<iid Xirnui' and ihuh r*r>^'-^^ thf: paütni 
1^ ^nHb'.Toic fia^u Gravc' divrav: and l<^xi( nrxiular ^riiei . 

2- 1€ tksr-To^ ibmiid cancCT Dwu* afv:r ablati'jn 'i Üie tbyroid 
and |>r*rparai'i^ ic aanuniriraiiou <A thiouracil ; . 

;>. IC mouu: b>prrwh^T<jidisnri in nevereh ill cardiac paüenu tn 
dwilr•>^inr yar. d liKtir n'/niia) tbyroid jrland and thub k/wering ihc 



90 



T//£ KIMMELSTIEL-WILSON SYNDROME 
AND ITS CLINICAL VARIANTS 

Harold Rifkin 

In 1936 Kimmelstiel and Wilson described characteristic post- 
mortem findings in the kidneys of 8 patients, seven of them known 
diabetics. The clinical records revealed that all these diabetic patienls 
had albuminuria, hypertension, edema, and azotemia. Numerous 
reports have appeared attesting to the clinical importance of this Syn- 
drome. Although originally considered to be a disease of middle-aged 
and elderly diabetics, this so-called "complication" of diabetes is now 
known to occur also in children and adolescents whose diabetes has 
been manifest for at least ten ycai-s. The gravity of this Syndrome is 
emphasized by reports that diabetic nephropathy takes first place as 
the cause of death in patients who had diabetes for twenty years or 
longer. 

The fully developed Syndrome include^ retinopathy, proteinuria, 
hypertension, nephrotic and/or cardiac edema, and azotemia, in asso- 
ciation with mild or severe diabetes. Occasionally, a patient may be 
observed from the onset of his diabetes through the various stages of 
the complicating Syndrome. More frequently, however, time of onset 
and rate of the syndrome's progression are not known when the 
condition is diagnosed. There seems to be no doubt that the renal 
lesion is just one manifestation of the widespread angiopathic changes 
that develop in the course of the diabetic metaboHc disorder. In a 
large group of patients studied at Montefiore Hospital we could 
observe the foUowing clinical variants of the Syndrome: 

1. Diabetes mellitus, hypertensive disease, edema, proteinuria, and 
retinopathy; this represents the fuU-blown Syndrome. 



91 



7 Virchow Society, Vol. 12 (1953) 



2. Mild diabetes mellitus, retinopathy, peripheral vascular disease, 
and proteinuria with or without hypertension or renal insufficiency. 

3. Diabetes mellitus, hypertensive disease with or without cardiac 
failure, and proteinuria. 

4. Diabetes melütus, arteriosclerotic heart disease, congestive failure, 
proteinuria, and retinopathy. 

5. Renal insufficiency and/or edema of undetermined etiology in a 
latent diabetic patient with some other major illness. 

6. Nephrotic Syndrome in a juvenile diabetic with retinopathy, with 
or without hypertension or renal impairment (in their early stages) . 

7. Diabetes mellitus, peripheral neuropathy, retinopathy and prot- 
einuria. 

All available data indicate that there is no correlation between 
the incidence of the Syndrome and the patients' age or sex or the in- 
tensity of the diabetic disorder. Evidently, the most important etiologic 
f actor is the duration of the diabetes. The earliest observed appearance 
of renal lesions is 8 years after the onset of manifest diabetes. 

I should like to discuss briefly the clinical and postmortem find- 
ings in a recent series of 21 patients, from 45 to 65 years old. The 
diabetes was mild, moderate or severe. All patients had hypertension, 
with the exception of two in whom autopsy disclosed extensive 
myocardial infarction. A constant finding was the characteristic retinal 
microaneurysms of diabetes, in addition to extensive retinal hemorrh- 
ages and exudates. Edema was noted in approximately 75 % of the 
patients. No correlation could be established between the severity of 
the edema and the degree of hypoalbuminemia. In the older age group 
edema was chiefly due to congestive heart failure while nephrotic 
edema prevailed in the younger patients. A moderate to severe anemia, 
and azotemia was an almost constant feature. 

The prognosis is poor regardless of the clinical picture. The aver- 
age life expectancy foliowing the onset of the Syndrome is 6 to 7 years, 
with a ränge of 2-13 years. Uremia, myocardial infarction, and acute 
cardiac failure are the most frequent causes of death. Renal pathology 
consisted of afferent and efferent arteriolosclerosis and intercapillary 
glomerulosclerosis of varying degrees. 



92 



Differential diagnostic considerations must take into account the 
patient's age. In the young diabetic, the nephrotic or hypertensive 
stages of chronic glomerulonephritis as well as chronic Pyelonephritis 
offer the chief diagnostic difficulties. In the elderly diabetic patient, 
co-existent hypertensive or arteriosclerotic renal disease with or without 
congestive heart failure, chronic Pyelonephritis, and renal amyloidosis 
(tuberculosis!) have to be considered. 

In our experience the diagnosis of the Kimmelstiel-Wilson Syn- 
drome is greally aided by these test procedures: 1 . Examination of the 
urinary sediment for anisotropic material, i.e. doubly refractile lipoid 
droplets enclosed in epithelial cells or casts. Under ordinary light, they 
appear yellowish-black ; under polarized light, they can be easily 
recognized as the well known maltese crosses. The amount of aniso- 
tropic material present in the urine varies from day to day. The lipoid 
droplets are best demonstrated in fresh, acid urine, but are difficult to 
find in poorly preserved alkaline samples. Needless to say that these 
elements are significant of the K.-W. Syndrome only when other dis- 
eases are ruled out as the potential cause of "lipoid" excretion in the 
urine, particularly chronic glomerulonephritis in cases of young dia- 
betics. If red blood cells and hemoglobin casts are found, one should 
consider the presence of the K.-W. Syndrome as extremely unlikely. 

2. Electrophoretic analysis of plasma and urinary proteins. The 
K.-W. Syndrome shows the foliowing pattem in the serum: a low 
albumin, an elevated alpha-2 and beta globulin, and a normal ganmia 
globulin. The urinary pattem signifies the preponderance of albumin 
and alpha- 1 globulin, with normal i.e. small amounts of the beta and 
gamma globulin f ractions. In contrast, patients with nephrotic glomer- 
ulonephritis have a serum pattern characterized by abnormally low 
gamma globulin. In renal amyloidosis, ganmia globulin is increased 
in serum and urine. Normal alpha-2 globulin and elevated beta 
globulin is the serum pattem found in diabetics with hypertensive or 
arteriosclerotic heart disease. Whether the elevated serum alpha-2 
globulin in patients with Kimmelstiel-Wilson Syndrome is simply the 
result of mesenchymal injury and prolonged proteinuria or represents 
an abnormality that is specifically associated with diabetic glomerulo- 
sclerosis, cannot be determined at present. 



93 



Renal clearance tests have proved to be of no value in the dia- 

gnosis of the K.-W. Syndrome. , , ^ t 

Finally, renal biopsy as recendy recommended by Iverson et al. 
may prove to be an invaluable aid in diagnosis ^ . . ^ 

Disturbances of lipid metabolism as well as alteraüons m the 
metabolism of complex mucopolysaccharides may be involved in the 
pathogenesis of the Syndrome. Elevated levels of cholesterol and 
phospholipids as well as marked elevation of the Sf 12-20 class of 
lipoproteins have been found in the blood of patients presentmg the 
Syndrome. Furthermore, complex carbohydrate substances have been 
demonstrated histologically in the hyaUne material of the retmal and 
renal lesions. That the deposition of this material might be due to an 
abnormally high concentration of circulating glycoproteins, as sug- 
gested previously, is indicated by our recent studies. Total serum Poly- 
saccharides bound to protein and glucosamine, were found to be in- 
creased only in those diabeüc patients who showed retinopathy, neuro- 
pathy or the fully developed K.-W. Syndrome. In the absence of 
degenerative vascular disease, neither diabetics nor non-diabetic 
patients, with or without arteriosclerotic disease, exhibited these 
Chemical abnormalities. Renal insufficiency cannot be the sole cause 
of these abnormal levels of glycoprotein. 

Our preliminary studies on the relationship between glycoproteins 
and lipoproteins in the serum of Kimmelstiel-Wilson patients indicate 
that the increases in alpha-2 globulin and complex carbohydrates run 
parallel. 



94 



MEDICAL MANAGEMENT OF PERIPHERAL 
VASCULAR DISEASES IN DIABETES 

Heinz I. Lippmann 



With few exceptions occlusive arterial disease in diabetic patients 
is due to arteriosclerosis. Since the etiology of arteriosclerosis is not yet 
known, no causal treatment exists at present. Medical management is, 
therefore, confined to the therapy of Symptoms. Accordingly, the dis- 
cussion tonight will deal with the treatment of conditions which re- 
present the most frequently seen manifestations of peripheral vascular 
disease in diabetic patients: 

1. UncompHcated arteriosclerosis obliterans. 

2. Infections (local, septic). 

3. Ulcerations. 

4. Gangrene. 

Time does not permit to consider diabetic neuropathies, acute 
arterial occlusion, venous and lymph vessel diseases, and the pre- and 
postoperative medical care. 

1, UncompHcated arteriosclerosis obliterans (ASO) (Table 1) 

The Cardinal Symptom is intermittent claudication. Objective 
sings are blanching on elevation and rubor in dependency, absent 
pulses on f oot and leg, and abnormal oscillometric and thermometric * 
findings, particularly following posterior tibial nerve block with pro- 
cain or intraarterial injection of small amounts of priscoline. Other 
diagnostic methods such as plethysmography, calorimetry, arterio- 

* A reliable pocket-size skin thermometer is supplied by Marcks, Ltd., London. 

95 



Manifestations: 



Table 1 

Arteriosclerosis Obliterans 

(Intimal thickcning, thrombotic occlusion) 

Intermittent claudication. 
Blanching on elevation, rubor on dependency. 
Absent pulses (palpation, oscillometry) . 
Low skin temperature after vasodilatation. 



Medical management: Protection from heat or trauma. 

Exercise - No smoking - Cleanliness - Avoidance of 
hypoglycemia, of acidosis - Oral vasodilators 



Of douhtful value. 



Sympathetic blockade - Vitamins (A, C, E) 
Intra-arterial vasodilators. 



graphy and radioactive soduim clearances are procedures not feasible 

for office use. 

Arteriosclerosis, at least in the diabetic, is basically a progressive 
disease. However, ASO may become stationary for many years. The 
formation of collateral vessels which is the rule in untreated cases, may 
be enhanced by muscular exercise. Walking (but not beyond the 
onset of intermittent claudication) is the best therapeutic procedure 
known at present. Oral vasodilators are commonly given in these 
cases, but it is doubtful whether any medication, oral or parenteral, is 
of actual help. The same is true for all physiotherapeutic procedures 
known to me. Sympathetic nerve blocking and lumbar sympathectomy 
have been ineffective in the many patients I have had an opportunity 
to observe. I feel certain that favorable reports conceming sympa- 
thectomy ( 1 ) and intraarterial therapy (2) for intermittent claudica- 
tion will not stand the test of time. 

The main efTorts in the management of ASO in the diabetic must 
be directed towards Prophylaxis. Mechanical and thermal trauma to 
the involved limb must be carefully avoided. Still, in more than 50 % 
of our hospital patients minor bums were responsible for gangrene 
of feet or legs. It is clearly the medical profession's responsibility that 
patients realize the danger of applying direct heat to limbs showing 
signs of impaired circulation. Proper hygiene should include a daily 
foot bath in lukewarm soap water and application of mineral oil or 
lanolin to the skin. The patient should have his toenails clipj>ed, but 



96 



should not do it himself . If trauma occurs, he should consult his phy- 
sician without delay. 

Some measure of protection may be obtained by lumbar sympa- 
thectomy (3) or intraarterial vasodilator therapy (4) in ASO in 
diabetics. 

In Order to bring home to every patient the nature of ASO and 
the importance of prophylaxis, I have found it expedient to band out 
typewritten instructions, adapted to the patient's educational back- 
ground . 

No patients with ASO should be permitted to smoke. In hitherto 
unpublished follow-up studies on 400 patients observed over more 
than 10 years, and on another series of 250 patients followed over 
shorter periods of time, the f oUowing was found : In either group the 
smokers showed a statistically significant higher incidence of clinical 
deterioration than the non-smokers. ITiere was no smoker among 
those who improved, subjectively or objectively. It is often said that 
nicotin excercises its damaging effect by causing vasoconstriction. I 
believe that additional factors are involved in the deleterious action of 
tobacco. 

Hypoglycemic episodes should not be permitted to occur in a 
diabetic with ASO. I have the records of 12 such patients in whom 
hypoglycemia was followed by complete occlusion of the major leg 
arteries and distal gangrene. The occurrence of coronary thrombosis 
during hypoglycemia is common knowledge ( 5 ) . We fear overdosage 
of insulin more than occasional hyperglycemia in diabetics with ASO. 
I give these patients the minimum dose of insulin compatible with 
adequate nutrition. They should spill traces of sugar in the urine. 
The other extreme, acidosis must be avoided as well. 

2. Infections (Table 2) 

The "uncontrolled" diabetic tends to develop infections. When 
excessive foot Perspiration causes the skin to macerate, an intractable 
epidermophytotic infection may become amenable to treatment after 
sympathetic blockade or lumbar sympathectomy. 



97 



Table 2 
Infections 



Superficial infections 
e.g. Epidermophytosis 

Pyogenic inf. 

Deep infections 
e.g. Abscess, tendon inf. 
Phlegmone, osteomyel. 

Septic infections 
e.g. S.B.E. (carditis or angiitis) 
Septic thrombophleb. 

In all cases 



Management 



Fungicides - No penicillin - occasionally 
sympathetic blockade - Hygiene 

Antibiotics - wet dressings, lukewarm - 
I & D (e.g. paronycchia) 



Antibiotics - surgical management as in 
non-p.v.d. (Culture sensitivity not helpful) 

Antibiotics (Culture sensitivity helpful) 



Diabetic control 

Vigorous vasodilatation deleterious if 

circulation is good (skin maceration). 



In the treatment of pyogenic infections, antibiotic sensitivity tests 
in bacterial cultures have not been helpful in the choice of the Opti- 
mum dose or the appropriate antibiotic. Penicillin continues to be an 
cfifective agent in many cases. High antibiotic concentrations in in- 
fected tissues may be obtained by intraarterial administration (6). 
Howevcr, I do not believe that the clinical results after systemic ad- 
ministration are inferior. Apparently, an Optimum tissue concentration 
of an antibiotic can be obtained by intramuscular injection, or by oral 
administration. 

Intraarterial vasodilator therapy for diabetic infections should 
not be instituted in the presence of an adequate circulation. I have 
observed local peripheral edema, skin maceration and spread of the 
infection in several such cases. 

3. Ulcerations (Table 3) 

Treatment depends on the location and type of the ulcer, whether 
it is arterial or venous in origin, clean, infected or gangrenous, acute 
or chronic. 

Subungual epidermophytotic ulcers occur frequently in diabetics. 
If a small triangulär wedge is clipped into the nail, pus will often 



98 



i 



Location 
Subungual 

Digits 

Over digit joints 

Plantar (balls) Callus 



Lower leg (later.) 
Legs or thighs 



Table 3 
Ulcerations 

Usual cavise Management 

Fungus - mixed inf. Relieve nail pressure 

Trauma - arterial ins. i.a. vasodilators - sedation 

antibiotics 

Osteomyelitis? (X-ray) Local amputation - transmetatarsal 

amputation 

Careful debridement, pressure 
rehef, - antibiotics - vasodilators 

Sedation - dilators 



Arteriolosclerosis * 
Venous stasis * 



Supportive therapy (Unna boot, 
Ace supportive bandage, etc.) 



* Lues, squamous cell Ca. 

empty under pressure; at a later date, more nail plate may be removed, 
carefuUy avoiding trauma to the edges and the base. Removal of an 
ingrown nail is an operating room procedure in these cases, and should 
be done with chisel and drill from above; dystrophic thickened nail 
should be thinned down with a drill file. These techniques must be 
learned and whether an ulcer will heal or spread depends more on the 
manner of manipulating these Instruments than the procedure used. 
The general rule is to do as little as possible. 

4. Gangrene (Table 4) 

All factoi^ which contribute to the development of gangrene, 
namely ischemia, infection, trauma, pain and the general Status of the 
patient deserve equal therapeutic attention. 

Intraarterial vasodilator therapy, judiciously applied, has provcn 
valuable in the treatment of diabetic gangrene ( 7 ) . Intraarterial in- 
jection of vasodilators * is indicated only for the rehef of ischemia. 
There is some evidence that the formation of collaterals and cutaneous 
blood flow may be enhanced by a round-the-clock injection schedule, 

* Sustained vasodilatation is difficult to obtain with histamin, and its appli- 
cation is too cumbersome for general use. 



99 



Digits (toes, fingers) Foot, 

For the purpose of 
Prevention of spreading 

Control of pain 

Control of infection 

Demarcation 

Improvement of ischemia 

Promotion of healing after 
demarcation 



Table 4 
Gangrene 
Leg, Heel, Localised skin areas, Massive gangrene 

Medical management 

Thcrapeutic measurc 
Relief of local pressure - rest -? other 
General sedation - intraarterial procain 
Antibiotics (systemic) 

Preservation of body heat (cotton packing) 
Optimum moisture (bland ointments) - 

Intraarterial vasodilators 

Positive N-balance (nutrition, activity) 
Control of anemia (Fe, liver, transfusion) 

Granulation Tocopherols (systemic) 
Epithelization Vitamins A and D (local) 
Contraction unknown 



especially when combined with reflex heat (8). The amount of vaso 
dilator injected is kept short of causing systemic reactions. 

Buerger's exercises or the oscillating bed are often used. The value 
of these passive exercises has been questioned recently ( 9 ) . 

The control of pain is of utmost importance, since pain produces 
vasoconstriction and interferes in many ways with the general condi- 
tion of the patient. Narcotics are freely used if necessary and without 
fear of addiction. Procain injected intraarterially has proven valuable 
in some cases, but may cause vasoconstriction, thereby offsetting the 
analgesic effect. 

Any damage to the involved limbs must be avoided. Regulär ex- 
ercise should be given to all major joints. To prevent flexion con- 
tractures, removable plaster Splints must be applied in somes cases. 
All patients with gangrene have bed rest or wheelchair privileges as 
long as the progress of demarcation is not entirely satisfactory. A 
cradle should protect the foot. A foam rubber cushion should be 
placed under the leg, but the heel should not touch the mattress and 
the bed should be raised in such a way that the limb is kept level and 
is not elevated. 



100 



When demarcation is complete, formation of granulation tissue 
may be speeded up by oral administration of vitamin E ( alpha-toco- 
pherol). Unpublished observations suggest that its stimulating effect 
corresponds with its concentration in the blood. The blood level can 
be raised by oral, rarely by parenteral administration. 

Epithelization is enhanced by topical application of vitamin A 
and D or by ultraviolet irradiation. There is no known measure that 
would enhance wound contraction, the third known mechanism of 
wound closure. 

In conclusion it can be said that the paramount task of the medi- 
cal management is to prevent damage to a limb with poor circulation. 
The general condition of the patient must be watched continually. 
Antibiotics are given when needed. Intraarterial administration of 
vasodilators and analgesics offers promising results. The use of nerve- 
blocking procedures is occasionally indicated. To evaluate all these 
moddities, a thorough knowledge of the natural course of untreated 
occlusive arterial disease is indispensable. 

Nature is kind, whether the physician interferes or not. In my 
experience, about three quarters of the patients who develop a throm- 
botic occlusion of a sclerotic femoral artery will get away without the 
loss of the limb or even parts thereof. Many more patients with oc- 
clusive arterial disease die with their feet on than with their feet off 
and can be managed conservatively. Many limbs can be saved by 
medical means, even when ulcerations or gangrene give rise to addit- 
ional hazards. 

Every patient in need of a major amputation is a living symbol 
of our failure. However, even then his chances to resume a useful life 
in Society are not at an end. We have today in our midst one of the 
pioneers of conservative surgery for peripheral vascular diseases. Dr. 
S. Silbert's own presentation will bear better witness to his achieve- 
ments than any words. 

A diabetic patient's chance, then, to maintain his working capa- 
city has improved through the years. Let us work for better chances for 
the patient of the future. 



101 



REFERENCES 

1. De Bakey, M. E., O. Creech and J. P. Woodhall: Evaluation of Sympathec- 
tomy in Arteriosclerotic Peripheral Vascular Disease. J. Amer. med. Ass. 144, 

1227, 1950. . ^. 

2. Mufson, I.: A New Treatment for the Relief of Oblitcrative Diseases of Peri- 
pheral Arteries. Ann. intern. Med. 29, 903, 1948. 

3. Edwards, E. A. and C. Crane: Lumbar Sympathectomy for Arteriosclerosis of 
Lower Extremities. New Engl. J. Med. 244, 199, 1951. 

4. Lippmann, H. L: Unpublished observations. 

5. Gilbert, R. A. and J. W. Goldzieher: The Mechanism and Prevention of 
Cardiovascular Changes Due to Insulin. Ann. intern. Med. 25, 928, 1946. 

6. Glasser, S. T., J. Herriin jr. and B. Pollock: Intra-arterial Injection of Peni- 
cillin for Infections of the Extremities. J. Amer. med. Ass. 128, 798, 1945. 

7. Lippmann, H. L: Intraarterial Priscoline Therapy for Peripheral Vascular 
Disturbances. Angiology 3, 69, 1952. 

8. Kappert, A.: Zur Behandlung mit intraarteriellen Injektionen. Helv. med. 
Acta m', 25, 1947. 

9. Wisham, L. H., A. S. Abramson and A. Ebel: Value of Exercise in Peripheral 
Arterial Disease. J. Amer. med. Asso. 153, 10, 1953. 



102 



SURGICAL MANAGEMENT OF 
PERIPHERAL VASCULAR DISEASES 

Samuel Silbert 

Five levels of amputation should be considered in patients with 
gangrene of the toes or foot. Amputation of a gangrenous toe fre- 
quently results in a gangrenous wound, and is usually not advisable. 
On the contrary if there is ulceration of a Single toe, with or without 
osteomyehtis, amputation of such a toe usually heals by primary union 
and saves many weeks of disabiUty. When gangrene involves two or 
more toes, a transmetatarsal amputation should usually be done. 
About 65 % of such amputations result in good healing. The great 
advantage of a successful transmetatarsal amputation is that a pro- 
thesis is not needed. When gangrene extends beyond the toes to in- 
volve the foot, and when there is gangrene of the heel, a mid-leg 
amputation should be done, saving the knee Joint. The advantages of 
mid-leg amputation are: reduced operative mortality, improved out- 
look for rehabilitation and absence of f>ersistent pain in the stump. In 
patients who are veiy toxic, it is frequently desirable to do a preUmin- 
ary quick guillotine amputation just above the ankle in order to remove 
the gangrenous or infected foot. The general condition of the patient 
usually improves rapidly following this simple procedure, and se- 
condary amputation through the mid-leg can then be done safely. 
Mid-thigh amputation is reserved for the sj>ecial case where gangrene 
extends almost to the knee Joint, or where there has been insufficient 
time for development of coUateral circulation to the midleg following 
an acute femoral artery closure. 



103 



OCULAR MANIFESTATIONS IN PROTRACTED 

DIABETES 

Georges Kleefeld 

Diabetes per se is one of the worst enemies of the eye. Cure and 
maybe, someday, prevention of this disease will be a boon for 

humanity. 

Thus the physician should be trained for the detection of the 
earliest signs of eye changes at a time when still some therapeutic 
measures might be considered. 

Forty years ago, people were not routinely examined for gly- 
cosuria. The ophthalmologists were practically the only ones who 
were trained in the use of the ophthalmoscope, and capable of making 
the diagnosis of "diabetic retinitis", as this condition was called at 

that time. 

Today, every physician knows and possesses this instrument for 
gazing at the fundus of the eye. The general practitioner has to be 
familiär with the ophthalmoscope because he is the one who has to 
see the first signs of a retinopathy. And he has to perform the ophthal- 
moscopy without artificial dilatation of the pupil, because instilHng 
any kind of mydriatic can lead to the development of glaucoma, and, 
positively, he should not take any chance. It is our belief that the physi- 
cian who takes care of a diabetic case has the same responsibiUty when 
it comes to the detection of acidosis or to the detection of the first 
appearances of diabetic retinopathy. The ophthalmologists will be 
always very happy to discuss these findings with the general practi- 
tioner who detected them. Once the diagnosis of retinopathy is firmly 
established, a steady Cooperation of general practitioner, laboratory 
and ophthalmologist will be required. 

104 



A routine examination of a diabetic should not bypass the ex- 
temal aspect of the eyes, nor should the interrogatory fail to include 
some very important points: whether the eyes are painful ( Symptom 
of a possible iritis-glaucoma) ; whether the vision is faihng (iritis - 
cataract - retinopathy ) ; whether there is double vision ( involvement 
of eye-muscles) ; whether some days the vision is better than others 
( swelhng of the lens going parallely with the variations of glycemia ) . 

The present concept in the evolution of diabetic retinopathy can 
be deducted from papers issued by the English School (Ballantyne) 
and Johns Hopkins University (Friedenwald, Becker). The first ap- 
pearance is a change in the veins of the retina. They lose their tonus, 
become irregularly enlarged. Their irregulär shape contrasts with the 
regulär pattem of the arteries. Friedenwald insists upon the presence 
of microaneurysms in the macular region as the forerunner of a dia- 
betic retinopathy. These microameurysms are fairly well pathogno- 
monic of that condition. Later on appear the hemorrhages, varying in 
aspect according to their locations in the retina. Roundish yellowish 
exudates develop in the same region ; they coalesce and form irregulär 
scalloped masses, which contain frequently cholesterol crystals. 

If the disease takes on a malignant character, hemorrhages spread 
into the vitreous body, and lead to proliferant retinitis with secondary 
incurable detachment of the degenerated retina, and blindness. 

How Stands the problem of diabetes as connected with ophthal- 
mology? Diabetes Mellitus in the past was synonymous of glycosuria. 
This simplified concept is no longer accepted. Aglycosuria in diabetics 
does not bring about either the disappearance or even the arrest of 
the "so-called" diabetic eye lesions. The factor "sugar" is not the only 
one which has to be considered in the genesis of the eye changes. 

It seems fairly well established that these changes occur only in 
protracted cases. All of the old diabetics are not necessarily Ophthal- 
mologie cases. One should not forget that most of the old diabetics 
show sclerosis of the blood vessels; whether the diabetic disorder leads 
to this sclerosis or whether there is a concomitance of diabetes and 
sclerosis is hard to say. 

In the Kimmelstiel-Wilson disease corpuscles are found in the 
kidneys which show microaneurysms very similar in apf>earance to 



105 



those observed as a forerunner of diabetic retinopathy. By injecting 
rabbits with alloxan and corticotropin Becker and Friedenwald suc- 
ceeded in producing renal and retinal lesions resembling those observed 
in man. These experiments as well as studies on diabetics have led 
them to conclude that there might be some logic in treating diabetic 
retinopathy by adrenalectomy. 

Recently, Peiner and Waldman have explored and advocated 
the treatment of diabetic retinopathy with testosterone and estrogens. 
These hormones are considered as antagonizing the action of corticch 
tropin. 

Researches pertaining to the use of Cortisone and cortisone-like 
substances in ophthalmology started with a systemic administration of 
these hormones. Later on, Cortisone and hydrocortisone were appüed 
topically in the conjunctival sac or undemeath the conjunctiva. At 
present we know that Cortisone therapy may lead to glycosuria. Treat- 
ing eye conditions with these hormones may thus lead to glucosuria. 
Cortisone instilled in the conjunctival sac may pass through the tear 
duct and into the circulation. In particular, with the so-called "local 
drip Cortisone treatment" (1 or 1.5 cc. of a 2J/2 % Solution of Cortisone 
in two minutes) the potentially absorbed amount of Cortisone is not 
negligible, especially if this administration is repeated a few times 
daily. It is obvious that any Cortisone treatment of eye conditons will 
require the constant supervision by the general practitioner. We say, 
"any Cortisone treatment", this means general as well as local. It can 
happen that a diabetic suffering from episcleritis requires topical 
Cortisone, or that a patient who has contracted an acute choroiditis is 
a diabetic. The close collaboration of intemist and ophthalmologist is 
the best safeguard against eye complications in diabetes. 



106 



INSULIN MANAGEMENT OF DIABETES 

Martin G. Goldner 

Insulin management permits the diabetic patient to maintain or 
to re-establish optimal nutritional Status with a minimal degree of 
hyperglycemia and glycosuria. Since maintenance of such optimal 
nutritional Status must be the therapeutic aim in diabetes mellitus, as 
long as a eure is not yet at hand, it follows that every diabetic patient 
who is unable to do so by dietary means alone, should be placed on 
insulin management. It also follows that insulin management is related 
more directly to the patient's nutritional requirements than to the 
severity of the diabetes, which is difficult to define and which may 
depend on many other factors in addition to insuHn deficiency. 

Insulin management Starts with dietary management. Optimal 
nutrition for the diabetic patient is the same as optimal nutrition for 
the non-diabetic. That is to say, that the diabetic organism has the 
same energy requirement as the non-diabetic and is subject to the same 
hazards of undernutrition and overfeeding. It is not possible in this 
context to evaluate critically the dangers of obesity ; it may suf fice to 
say that a diabetic patient should never be obese. A few words, how- 
ever, should be said about under-nutrition in diabetes. Under- 
nutrition was unavoidable in the pre-insulin era. Then, its dangers 
were obscured by the short life span of the diabetic patient. Since the 
advent of insulin, the life expectancy of the diabetic has become almost 
the same as that of the non-diabetic. It is, therefore, mandatory to 
provide for optimal nutrition in the management of all diabetic 
patients, children as well as adults. By meeting this requirement one 
will promote physical health and resistance, secure normal rate of 

107 



8 Virchow Society, Vol. 12 (1953) 



growth and development, and may ward off the onset of degenerative 
diseases threatening the diabetic most seriously in the presence of mal- 
nutrition. 

The proper diet should be as similar to a normal regimen as pos- 
sible: with regard to caloric value, to content of vitamins, minerals, 
etc., and to relative distribution of the nutrients. It should be cal- 
culated in relation to ideal weight for sex and age. If placed on such 
a diet (provided that insulin administration is adequate), the under- 
nourished patient will gain, the obese patient will gradually lose until 
they reach and maintain the desired weight. This procedure may be 
more time consumjng than the temporary use of reducing or high 
caloric diets with subsequent placement on maintenance diet; but it 
has the advantage that diet and insulin can be adjusted at once. For 
the average adult, such a diet will provide about 2500 calories and 
will contain 250 g. of carbohydrates, 100 g. of protein, and 100 g. 
of fat. Experience has shown that the best results are obtained when 
such a diet is administered in 4 meals (breakfast, lunch, supper, and 
bedtime feeding) and when 2/5 of the allotted carbohydrates are of- 
fered for breakfast, and 1/5 for each of the other meals. 

Only the mild diabetic (adult) will tolerate this kind of diet 
without receiving insulin. All other diabetics need Substitution therapy 
with insulin. They include the following groups: 1) all diabetic 
children; 2) adults who cannot adjust to the above maintenance diet; 
3) all cases of diabetes complicated by infection, surgical disease, 
pregnancy, diabetic acidosis and coma. 

Insulin management Starts after the patient has been placed on 
his proper diet. Insulin is adjusted to the diet, not the diet to an arbi- 
trär)' amount of insulin! The proper dose should be the minimal 
amount of insulin which will lower the hyperglycemia to almost nor- 
mal levels and decrease the glycosuria to a trace, without eliminating 
it entirely. The choice of this minimal effective dose is intended not 
only to prevent hypoglycemic reactions but also to prevent further 
depression of the remaining insulin producing power of the pancreas. 
It is rather well established that excessive exogenous insulin depresses 
endogenous insulin production. 

108 



Two types of insulin are presently at our disposal for insulin 
management: the slow-acting (long-lasting) and rapid-acting (short- 
lasting) preparations. The slow-acting are Protamine Zinc InsuHn and 
Globin Insulin or NPH (Neutral Protamine Hagedom); they are 
gradually absorbed over periods of 18 hours (NPH) to 36 hours 
(PZI) and have correspondingly prolonged action curves. They reach 
their maximal effect a few hours after injection. They are usually 
given once daily - NPH may sometimes be given twice a day, at 
12 hours interval. If spaced properly, two consecutive doses may 
overlap in their action, the slow, incoming effect of the new dose 
being superimposed on the waning effect of the preceding dose. This 
permits a sustained suppression of the fasting diabetic hyperglycemia. 
The steady rate of absorption does, of course, not adequately check 
the rise of the blood sugar that foUows intake of food. Nevertheless, in 
many instances when depression of the fasting level suffices to prevent 
excessive postprandial hyperglycemia, diabetes may be satisfactorily 
controlled by the use of slow-acting Insulins alone. 

However, in some forms of diabetes, particularly in children, the 
amount of slow-acting insulin required for adequate control during 
the period of food intake would precipitate hypoglycemia during the 
physiological fast at night time. In these cases, slow-acting insuhn is 
administered in smaller doses to guarantee a "basic" sustained anti- 
glycemic action. This must be supplemented by doses of rapid-acting 
insuhn, either regulär insulin, crystalline insulin or insulin derived 
from insuhn zinc crystals. They all reach the peak of their effective- 
ness in less than 30 minutes after injection and have exhausted 
their action after 3-4 hours. They are added usually to the basic in- 
suhn prior to breakfast (which should have the greatest carbohydrate 
content). If NPH insulin is used as basic insuhn, the supplementary 
dose of rapid-acting insulin and one dose of NPH can easily be mixed 
and injected through the same syringe. This should not be done, 
however, with PZI because this preparation contains an excess of 
Protamine and any admixed rapid-acting insuhn will be precipitated 
and converted into an insulin with long-lasting effect. 

More than 90 % of all diebetics can be controlled in this fashion. 
Only in the rare instance of the so-called briddle diabetes more than 



109 



one supplementär)' dose of rapid-acting Insulin may be required, for 
instance, prior to each of the 3 or 4 daily meals. Occasionally, even 
2 doses of NPH may have to be administered. 

Now a Word about the dosage. The dose required in the individ- 
ual Gase cannot be calculated from a simple formula. The rule that 
one Unit of insulin permits the utilization of 2 g. of sugar is more often 
wrong than right. In most instances, one has to find the adequate dose 
by trial and error. Since insulin management is not an emergency 
procedure (with the exception of coma), there is always ample time 
to increase a small initial dose until the minimal effective dose is found. 
The initial dose should generally not be higher than 20 units of slow- 
acting insulin or 10 to 15 units of rapid-acting insulin. Then, 5 to 
10 units are added at intervals of one or several days until urinalysis 
indicates that the minimal efiective dose has been reached. This 
method may be time consuming, but is certainly safer than to give an 
arbitrary large dose initially and decrease it gradually until the mini- 
mal eflective dose has been reached. The dose contained in a single 
injection should not exceed 80 units, except in the treatment of coma 
or insulin insensitivity. Slow-acting insulin needs time to estabHsh its 
füll effect. One will do best to give the same dose for 2 or 3 days 
before increasing it. Throughout the period of adjustment, urine 
should be examined for sugar ( qualitatively before each meal and, 
quantitatively in the 24 hour specimen ) . The f ollow-up of f asting and 
preprandial blood sugar levels is less essential than the urinalysis. When 
the 24 hour Output of glucose is less than 10 g., and when the degree 
of glycosuria is minimal throughout the day, the adjustment can 
be considered as satisfactory. If the glycosuria is heavy in only one of 
the composite urine specimens of the 24 hour output and absent in the 
others, the f ood distribution should be changed rather than the dosage 
of insulin or the caloric content of the diet. For instance, some of the 
carbohydrates are taken away from the meal preceding the heavy 
glycosuria, added to another meal or distributed over those meals 
following which the urine was found to be free or almost free of sugar. 

When diet and insulin requirement have been properly establish- 
ed, maintenance of control is the next task. On the suggested ade- 
quate diet, the patient has seldom the desire to cheat; this ehminates 



110 



one great hazard. In addition, the patient must be instructed how to 
administer his insulin, not to inject it permanendy at the same site, 
lest he may develop granulomata from which insulin is poorly ab- 
sorbed. He has to know not only the prescribed dose of insulin, but 
also how to measure it. 

He should be familiär with the various strengths of insulin pre- 
parations and learn to calculate the prescribed units from preparations 
which contain 40, 80 or 100 units in 1 cc. He also should be given 
an identification card, such as is issued by the American Diabetes 
Association, which identifies him as a diabetic patient and indicates 
the amount of insulin and the diet he is taking. Furthermore, he must 
know that even if he feels not well and is unable to eat his füll diet, he 
has to take his füll dose of insulin. Any intercurrent illness is apt to 
increase the insulin requirement or to decrease insulin sensitivity. Thus, 
in spite of decreased food intake, the same amount of insulin or even 
more, is needed. Omission of insulin because of an upset stomach or 
another minor illness is the most common cause of diabetic coma. 
Finally, the patient must be instructed about the Symptoms of insulin 
reactions and how to take care of them. He must know that he should 
seek the advice of his physician at regulär intervals and whenever the 
control of his disease becomes deficient, even if he himself was able 
to adjust the immediate derangement. 

These are the basic problems of insulin management; time does 
not permit to discuss special as{>ects, such as switching from one type 
of insuHn to another, insulin management of surgical complications, 
the management of diabetic coma, or the rare instances of insulin 
allergv' and insulin insensitivity. These, however, are situations which 
commonly require hospitalization, while the basic establishment and 
maintenance of insulin therapy is a matter of office practice. 

One more thought in closing; insuHn therapy is Substitution 
therapy. It has been tremendously successful. Nevertheless, it is not the 
ideal therapy. Insulin is secreted in constantly changing amounts into 
the portal System and reaches the periphery only after having passed 
the liver where it most likely exerts some of its effect or where it is 
altered. What we are doing, with insuhn administration, is to Substitute 
rather crudely subcutaneous injections for this internal secretion. 



111 



This may account for some of the difficulties in Insulin manage- 
ment. It may also account for the fact that we have to use far larger 
doses of insulin than those known to be secreted under physiologic 

conditions. 

Administration of insulin is the best therapy of diabetes today. 
Our goal, however, is not Substitution but eure and prevention. This 
is what present research in diabetes is striving for. 



112 



SUPERFICIAL ULCERATION OF THE 
URETHRAL MEATUS IN MALE CHILDREN 

Paul Freud 

Superficial ulceration of the meatus in male infants and young 
boys is not generally recognized as a definite entity, in spite of its fre- 
quent occurrence. 

The lesion consists of a superficial ulcer on the periphery of the 
meatus, cracking its labia to a width and depth of 1 to 3 mm. The 
ulceration always remains localized, sparing the inner surfaces of the 
Urethra. There is no urethral discharge. Crust formation leads readily 
to temporary obstruction of the Urethra and incomplete emptying of 
the bladder (divided stream or dribble). When the scabs come off, 
the first drop of urine touching the surf ace of the ulcer causes intense 
pain, and the children retain urine until an overflowing bladder 
enforces voiding. The condition does not cause fever. As soon as the 
scab peals off, bleeding occurs. Bright bloody Spots on the diapers are 
frequently the first Symptom that alarms the parents. Secretion on the 
surf ace of the ulcer soon Starts again, leading to formation of new 
obstructing crusts, bleeding and difficulty in voiding. This vicious 
cycle may come to a halt, eventually, w^hen the ulcer heals spontane- 
ously and leaves only small constricting scars. After a pause, the 
lesion reappears and, if not treated, heals again with scar formation 
and intensification of the stricture. Any stricture located at the orifice 
or higher up W\\\ eventually lead to urinary retention, with all its 
dangers of pressure damage and infection. 

Our experience based on the treatment of numerous cases shows 
that the disorder occurs only in circumcised children or when a wide 
prepuce leaves the tip of the meatus exposed to Irritation. 



113 



However, development of the lesion is always conditioned by a 
congenitally tight meatus (anterior-posterior diameter less than 
3 mm.) and the presence of a rash (ammonia dermatitis) or Herpes. 
They narrow the tight meatal opening still further (inflammatory 
swelling ) . 

Treatment consists of : 

1. Installation of 1 drop of a 2 % novocain Solution on the surface 
of the ulcer (relief of pain on voiding). 

2. Use of non-volatile antiseptics directed against the action of bact. 
ammoniagenes; impregnation of diapers and topical application 
( ointment ) . 

3. Repeated dilatation of the meatus in cases of moderate constriction ; 
meatomy and dilatations in cases of "pin point" meatus. 



» 



114 



SOME NON-TUBERCULOUS CHEST DISEASES 

IN CHILDREN 

Helene Eliasberg 

From the great variety of lung diseases in childhood I have chosen 
a group which has in common abnormal airspaces within or around 
the lungs. To be more specific I am going to discuss the occurrence of 
cysts, emphysema, abscesses and pneumothorax in infants and 
children. 

Cysts 

Lungcysts may be found at all ages; sometimes they are discovered 
by routine ehest X-rays without having caused any Symptoms. They 
may be single or multiple, but are usually located in one lobe. Some 
cysts are filled with mucoid fluid, secreted by the mucous glands in 
the Hning of the wall; most cysts are airfilled. The fluid cysts are more 
or less Stahle in size and do not cause respiratory disturbances. Air- 
cysts may communicate with a bronchus and if a check valve mechan- 
ism develops, they may enlarge to enormous proportions and cause 
serious displacement of the mediastinum and heart. They may burst 
and produce a tensionpneumothorax, or they may compress the ad- 
jacent lung tissue with ensuing cyanosis and severe respiratory and 
circulatory distress rcquiring emergency Operations. Besides these 
complications, caused by mechanical forces, infection is a great hazard 
in pulmonary cysts, more so in older children than in infants. These 
dangers inherent in pulmonary cysts are the reason why many p)edi- 
atricians and surgeons favor early Operation. After several bouts of 
infection have produced adhesions, purulent exudate within the cyst 
and blurring of the lobar demarcations, the Operation becomes more 



115 



difficult. Total pneumonectomy may be necessary instead of a seg- 
mental resection or lobectomy. Even if some of the patients escape all 
these complications, it seems to me of importance to restore the f unc- 
tion of at least part of their lung rather than to maintain a functionless 
cystbearing lobe (which compresses the adjacent lobes). Early lob- 
ectomy is tolerated remarkably well by infants. The remaining lobes 
expand well and fill the entire pleural cavity. The youngest baby that 
ever underwent a successful lobectomy was operated on the 7th day of 
its life by Whitesell and White. A total pneumonectomy was even 
performed on a 3 weeks old baby who had a large cyst in the upper 
lobe. The results were excellent (Gross). 

There are, however, other observers who advocate watchful 
waiting instead of immediate surgical intervention (Vollmer, Caffey). 
CaiTey reported recently on 13 cases of lung cysts in infants under 
6 months of age. Only 2 had to be operated on because of massive 
pulmonary emphysema. In the remaining infants the cystic lesions 
disappeared spontaneously after months or years. 

Another controversy concerns the question whether the cysts are 
congenital (intrauterine error in the embryonic development of the 
lungbuds) or acquired (early postnatal mechanical origin). Some 
cysts found in stillborns and newboms at autopsy and birth, respec- 
tively, are undoubtedly of congenital nature. On the other band, Caf- 
fey, Convey, Rappaport and Meyer believe that most lung cysts are of 
acquired origin even when bronchial epithelial lining, muscle and 
cartilage are found in their wall. CafTey bases bis opinion on 5000 
autopsies of newboms at Babies Hospital. The question is by no 
means theoretical since many surgeons insist that prognosis and therapy 
of congenital and acquired cysts are entirely different. Congenital cysts 
should be removed on account of the potential dangers mentioned 
above, whereas acquired cysts could be watched and rarely need Oper- 
ation. Acquired cysts usually can be traced back to a pulmonary in- 
fection, a factor which plays no etiologic role in the formation of the 
congenital cyst. 



116 



Emphysema 

Emphysema occurs in 2 forms, the compensatory and the ob- 
structive. Anatomically, the compensatory form is no true emphysema, 
but a reversible volumen pulmonum auctum: there is an increase in 
air content due to hyperventilatory function of a lobe or lung compen- 
sating for an atelectatic lobe. Clinically, one finds in addition to the 
atelectatic lung portion an enlarged size of part or whole of the remain- 
ing lung. On X-ray examination, the lung appears overaerated, the 
intercostal Spaces are widened, the diaphragm is depressed, the medi- 
astinum shifted to the opposite side. All these changes are more marked 
on inspiration. This type of emphysema is frequently seen in atel- 
ectasis of the newbom or following aspiration of foreign bodies if it 
results in total bronchial obstruction. 

While compensatory emphysema is the beneficial result of a 
Physiologie adjustment, the obstructive emphysema is a pathologic 
condition due to check valve type of bronchial obstruction. The over- 
aeration can be regional, lobar or may involve an entire lung. The 
X-ray findings are very similar to those seen in compensatory emphy- 
sema, except for the absence of atelectasis in other parts of the lung. 
For the differentiation of the 2 types, fluoroscopy is of greater hclp 
than the film, unless one can be sure to get 2 exposures, one in in- 
spiration, the other in expiration - a difficult task to achieve in 
children. 

Cases of obstructive lobar emphysema not due to demonstrable 
compression of any kind may require thoracotomy and lobectomy. This 
proved to be a life saving procedure in cases of emphysema that tumed 
out to be the result of vascular and other anomalies. Regional ob- 
structive emphysema due to a check valve mechanism in a small 
bronchus has been known as an important manifestation of pulmon- 
ary pathology since its first description by Caffey. Such an obstruction 
may occur in the course of a pneumonia and may result in the forma- 
tion of large tension cysts. Anatomically, they represent a gross disten- 
tion of alveoH, small bronchioli or bronchi, yet without much destruc- 
tion of lung parenchyma. The cysts may be Single or multiple; they 
are air-filled and contain only a small amount of fluid, if any. They 



117 



are called pneumatocele. It is most characteristic that they easily 
undergo Variation in size and that they have the tendency to disappear 
spontaneously. Though their appearance during the course of pneu- 
monia may suggest the diagnosis of a lung abscess, the differentiation 
is not too difficult. In contrast to the abscess, the cyst develops witliout 
serious Symptoms: there is no fever, no leucocytosis, no abnormal type 
of respiration, and no interference with the child's general condition. 
In fact, I believe that the development of a pneumatocele might ver)' 
easily escape recognition unless serial X-rays are taken. After the 
pneumonia has cleared up, these cysts may pei-sist for several months. 
When they disappear eventually they leave no residues; the lung tissue 
shows a completely normal structure. That the pneumatocele is actually 
due to a bronchial check valve obstruction has been confirmed by the 
finding of raised gas pressure within the cyst. In rare cases of very high 
pressure in a superficially located pneumatocele, an air bleb may burst 
and produce interstitial emphysema or pneumothorax. It is the rule, 
however, that the regional obstructive emphysema disappears with the 
Clearing of bronchial obstruction, without any therapy. It is inter- 
esting that in the majority of the reported cases the bacteriological 
examination revealed an infection with staphylococcus hemolyticus 
aureus. 

In the following films I will demonstrate some of the diagnostic 
difficulties relating to cysts. Diffuse bilateral obstructive emphysema 
due to bronchospasm and check valve occlusion of small bronchioli 
is the main feature of bronchial asthma, at least in children. There- 
fore, whcezing is very often diagnosed as bronchial asthma. However, 
one should always bear in mind that asthma is a bilateral condition. 
Unilateral conditions, e.g., one-sided bulge or lag, combined with 
wheezing, predominantly present over one lung have to be carefully 
studied until the cause of the obstruction is found. 

Lung Abscess 

The counterpart of the transient cysts in regional obstructive 
emphysema are the permanent cavities as seen in pulmonary abscesses. 
Here, severe tissue destruction takes place, either in pyogenic non- 

118 



resolving pneumonic infiltrations, in necrotizing infarcts or in caseous 
tuberculous infiltrations. Bronchiectatic cavities also tend to develop 
abscesses, especially after prolonged Stagnation of purulent exudate. 

An incipient pneumonic pulmonary abscess may present a diffi- 
cult diagnostic problem. With a rise of temperature, high leucocytosis 
and the signs of severe illness, it is not always possible to establish the 
diagnosis, even if one suspects abscess formation. If one goes in with 
a needle, one will hardly hit a deep seated small abscess, and X-rays 
will not reveal anything but a definite pulmonary shadow in this early 
phase. With progressing necrosis and liquefaction the pulmonary 
shadow becomes less dense in the center. Eventually, when communi- 
cation with the bronchus is established and air enters the cavity of the 
abscess, the X-ray findings become characteristic : fluid-air level within 
a cavity that is surrounded by a broad ring of infiltrated lung tissue. 
By contrast, pleural empyema leads to displacement of heart and 
mediastinum away from fluid shadow or empyema. However, to make 
things more difficult, it is by no means rare that one has to deal with 
simultaneously existing empyema and lung abscess. 

Like pneumonia, lung abscesses in childhood are f requently caused 
by aspiration of foreign bodies, especially grains carrying bacteria and 
fungi. Pulmonary abscesses following tonsillectomy have fortunately 
become rather rare, thanks to the prophylactic use of antibiotics and 
sulfadrugs, proper postural drainage and suction during Operation. 

Spontaneous Pneumothorax 

So called spontaneous pneumothorax is not infrequent in child- 
hood. One may find it already in the newbom. Here, it is usually due 
to rupture of an emphysematous bleb in compensatory as well as in 
obstructive emphysema. However, obstructive emphysema is more 
likely to cause rupture and subsequent pneumothorax because the 
check valve mechanism induces steadily rising pressure. The prognosis 
of this condition in the newbom is better than one would expect. As 
soon as the intraluminal bronchial obstruction is released the emphy- 
sema disappears and the pneumothorax is quickly absorbed. This form 
of neonatal pneumothorax is usually discovered only by X-ray. In 



119 



older children, congenital bullae or blebs, trauma, tracheotomy and 
tuberculosis are the main causes of pneumothorax. Clinically, there is 
sudden pain in one side of the ehest, severe dyspnoe, cyanosis or shock; 
occasionally, when the amount of air escaping into the pleural cavity 
remains small, only slight discomfort may be feit. The involved side is 
bulging and lagging in respiratory expansion. The radiologic signs are: 
collapse of the lung towards the pulmonary root ; if adhesions exist the 
collapse is not complete and the fibrous Strands extending from the 
lung surface to the parietal wall cause sharp, irregulär, angular con- 
tours of the coUapsed lung, over which the pleural lining is visible. 
The airspace surrounding the lung does not show any pulmonary 
markings, as seen in emphysema. 

If the intrapleural pressure is elevated, the intercostal Spaces are 
markedly widened, the diaphragm depressed, the mediastinum and 
heart displaced to the opposite side. Sometimes fluid appears (serous 
fluid, blood or pus) and produces the characteristic horizontal air- 
fluid line. The presence of a valvulär mechanism at the tear leads to 
the development of a tension pneumothorax, with herniation into the 
mediastinum and the opposite pleural cavity, causing extreme dyspnoa 
and cyanosis. 

Such paüents have to be treated with conti nued closed aspiration 
by airsealtubing through a thoracocentesis. If there is no emergency, 
the pneumothorax is best left alone, permitting spontaneous ab- 
sorption. 

In conclusion I would like to stress the following points: In any 
patient presenting Symptoms of respiratory distress the diagnosis and 
prognosis should be firmly established. Whether the management 
should be conservative or surgical will depend on the results of serial 
X-ray examinations, bronchoscopy and bacteriological and clinical 
studies. The age of the patient is not a contraindication, neither for 
bronchoscopy nor for surgery. 



120 



APOCRINE SWEAT GLANDS AND SEXUAL 

DEVELOPMENT 

H. Behrendt 



The pH on the surface of the axilla was tested colorimetrically in 
502 boys of various maturity groups, including preadolescents and 
adolescents. The results can be summarized as foUows: 

1 . The acidity on the surface of the axillary vault decreases consider- 
ably when the apocrine sweat glands in that area supply "alkaüne" 
sweat. 

2. The axillary vault pH indicates the presence or absence of apo- 
crine sweat production. 

3. The activation of apocrine sweat glands coincides with one of the 
phases of sexual maturation in boys. 

4. The frequency distribution of pH readings on the axillary vault 
among boys of diflerent sexual maturity shows a steady increase in 
the number of "positive apocrine" readings from preadolescence 
through maturation. 

This shift of pH from acid to neutral or alkaline values (on the 
axillary vault) is one of the chemical signs of sexual maturation. 



D. 



DISCUSSION 
H. Vollmer 

Dr. Freud's paper is of practical importance. Due to their locali- 
zation, these lesions cause undue concem to parents and at times 
puzzle the physician. As a rule, they yield readily to treatment with 
indifferent ointments and control of ammonia formation. The most 



121 



common mistake is overtreatment which adds a therapeutic to ihe 
etiologic irritant, aggravating the condition. Antibiotic ointmenls may 
cause sensitization and their use should be restricted to cases in which 
secondary infection is obvious or bacteriologically proven. I wonder 
whether local application of hydrocortisone should be tried to avoid 
swelling, fibrosis and scaring. It is not for me to decide whether pedi- 
atricians or urologists are right with their etiologic concepts. Do we 
have valid Standards as to normal size of the urethral meatus during 
infancy? Personally I have difficulties in understanding why a slight, 
functionally insignificant narrowing should cause such ulcerations. 
Most pediatricians agree that narrowing is the result rather than the 
cause of these lesions. 

Dr. Behrendt, in his modesty, told me that he is going to present 
"an insignificant physiologic contribution". A study of such thorough- 
ness is always significant, particularly if it concems puberty, a period 
so long neglected by both intemists and pediatricians. To take care of 
this age period is so to say the great finale of the pediatrician's job. 
Physiologic studies are basic in opening a new field to our understand- 
ing. Practical appHcation of such knowledge will follow in due time. 

Sweating can be caused experimentally by hypothalamic Stimu- 
lation. Puberty is believed by many to be initiated by hypothalamus- 
pituitary mechanisms. It is therefore no surprise that puberty is ac- 
companied by changes in sweat composition. The acidity of other 
secretions such as vaginal secretions is changed in the opposite direc- 
tion. Besides the acidity, there may be other changes not yet under- 
stood which explain the spontaneous eure of tinea capitis at the age of 
puberty. To speak of another age period: Why does Leiner's disease 
clear up spontaneously at the age of 3 months? We don't know. Dr. 
Behrendt opened an important new field for study and we all hope he 
continues his work. 

Dr. Eliasberg together with Neuland in 1920 made an essendal 
contribution by their classic description of epituberculosis. Today Dr. 
Eliasberg presented interesting ehest conditions which attracted in- 
creasing attention in recent years. If I may add an early own Obser- 
vation: In 1927 I described a 6 year old girl with a pulmonary cavity 
and an air-fluid level. In spite of negative tuberculin tests, Finkdstein 



122 



wamed against my conservative attitude and thought this cavity to be 
tuberculous. The child did well without any treatment. Re-examin- 
ation 21 years later revealed that this cavity had persisted without any 
change. The course was asymptomatic. Emphysematous cavity was the 
most probable diagnosis. This case was one of the first described in the 
Uterature with the longest foUow-up period. It teaches that not all 
emphysematous cavities disappear spontaneously and that, never- 
theless, a conservative attitude is to be recommended. 

May I re-emphasize the importance of tuberculin tests for differ- 
ential diagnosis. Their importance increased with the decrease of 
positive reactors in the population. When Pirquet described his cutane- 
ous test 50 years ago, neariy 100 % of the Vienna population of 
military age was tuberculin positive. Therefore, the test was not of 
great diagnostic help except in early childhood. The Situation today 
and in the United States is entirely different. In recent years, among 
all admissions to Babies Hospital from birth to puberty only 3 % posi- 
tive reactors were found. It is obvious that under these circumstances 
a positive tuberculin test assumes a much greater significance. 

Dr. EHasberg's excellent presentation deserves a more competent 
discussion than I can offer. We are fortunate in having with us Dr. 
John Caffey of Babies Hospital, our great expert in pediatric roent- 
genology. Dr. Caffey graciously agreed to discuss Dr. EHasberg's paper. 



123 



9 Virchow Society, Vol. 12 (1953, 



OBITUARIES 
Read by Paul Hoch 

Dr. Hedwig Zweig 
Dr. Hedwig Zweig was graduated in 1922 from Breslau. She was 
then Assistant at the Pediatric Clinic with Professor Stolte at Breslau. 
Later she was Assistant of Professor L. F. Meyer at Berlin. For four- 
teen years she practised as a pediatrician in Gleiwitz. In 1940 she 
went to Shanghai and worked at the American Mission Hospital with 
Chinese war orphans. In 1941 she came to New York and became 
assistant of Dr. Herman Schwartz. Dr. Zweig was on the staff of the 
Pediatric Department of Beth Israel Hospital and was a Pediatrician 
to the Health Department of the City of New York. Wherever she 
worked she devoted herseif wholeheartedly to her patients and was 
mach beloved and respected by her co-workers. 

Dr. Rudolph Hoeber 

was bom in Stettin in 1873. He studied medicine in Erlangen, Frei- 
burg and Berlin. He received his doctor's degree in Erlangen in 1897. 
In 1898 he became Privatdozent for Physiology in Zürich. In 1909 he 
went to Kiel where he became füll professor of Physiology in 1915. He 
made outstanding contributions to physiology. His book "The Physi- 
cal Chemistry of Cells and Tissues" which appeared in 1902 was a 
fundamental work in this field. Later he wrote his textbook on 
physiolog)' which was widely used and esteemed. He also wrote "The 
Physical Chemical Investigative Methods of the Animal Cells and 
Tissues" in which he summarized the great progress made in this 
branch of science. His many publications dealt mainly with physics 
and chemistry as applied to physiology. 

Dr. Max Einhorn 

Dr. Max Einhorn was an outstanding gastroenterologist who 
died at the age of 9 1 . He was Consulting physician to the Lenox Hill 
Hospital who gave that Institution the Max and Flora Einhorn Build- 
ing and donated funds for awards to care for patients with gastro- 
enterological ailments. He was on the faculty of the Post-Graduate 
Medical School from 1889 to 1922 when he became emeritus profes- 

124 



sor of medicine. Dr. Einhorn invented the stomach bücket, a method 
of transillumination of the stomach, a duodenal tube for diagnosis and 
treatment of intestinal disease, a pyloric dilator catheter for infants, 
and a fermentation saccharometer. He was the author of "Diseases of 
the Stomach" which appeared first in 1896, "Diseases of the In- 
testines", in 1900, "Practical Problems of Diet and Nutrition", in 
1905, "Lectures on Diabetes", in 1914, and the "Duodenal Tube and 
Its Possibilities", in 1920. Dr. Einhorn who retired about fifteen years 
ago remained active until shortly before his death. For his outstanding 
achievements in medicine he held honorary degrees of the University 
of Tokyo. He was a member of most of the American national so- 
cieties in medicine and was honorary member of the medical society 
of Munich, and of the Parisian, Japanese, and Belgian gastroenter- 
ological associations. With Dr. Einhorn's passing the Rudolph Vir- 
chow Society lost one of its most respected members. 

Dr. Julius Fuchs 

Dr. Julius Fuchs died at the age of 65, August 15, 1953. Dr. 
Fuchs was an intemationally known orthopedic surgeon and founder 
of the treatment method, orthokinetics. He was bom in Baden, 
Germany and received his medical degree at the University of Heidel- 
berg in 1913. He was Chief Orthopedic Surgeon of the Veterans 
Hospital in Baden, Germany until 1920 when he founded his own 
orthopedic Institute in Baden-Baden. It was here he developed liis 
technique of orthokinetics which used flexible devices instead of rigid, 
plastic casts to brace orthopedic injuries, and thus allow limb motion. 
He came to the United States in 1 940 where he continued his experi- 
ments. He wrote many textbooks and articles on orthopedics in both 
English and German. His latest was "Principles of Orthokinetics", 
published in 1 95 1 . 

Dr. E. David Friedman 

Dr. E. David Friedman was born in New York City, attended 
C.C.N.Y., and received his Medical Degree from New York University 
in 1907, after which he did post-graduate work at the Universities of 
Vienna and Berlin. He held numerous important staff appointments 
in New York hospitals. He was visiting neuropsychiatrist of the Gold- 



125 



water Memorial Hospital, Chief of the Neurological Service of Belle- 
vue Hospital, Director of the Neurological Service of Beth Israel 
Hospital, and many others. He was Professor of Neurology at New 
York University from which position he retired in 1947. He continued 
his numerous activities in the field of neurology after his retirement. 
In 1949 he received the Townsend Harris Medal from City College 
for outstanding post-graduate achievement in "some significant field 
of human endeavor". He was President of the Park Avenue Syna- 
gogue and had been actively interested in many Jewish educational 
organizations. He was an outstanding neurologist with a great clinical 
knowledge. He was recognized as an outstanding teacher and his 
kindly and understanding personality made him much loved by his 

students and patients. 

Dr. Ernest Myller 

was bom in Schmalkalden 60 years ago. He graduated from the Uni- 
versity of Beriin in 1918. By the eariy 30's he had become chief gyne- 
cologist and head of a hospital in Nuremberg. After the rise of Hitler 
to power in 1933 Dr. Myller and his family were forced to flee to 
Greece. There he passed the medical examinations and opened a 
private hospital in Athens which he headed for the next 7 years. When 
the war began Dr. Myller undertook secret work in Greece for the 
British Intelligence and in 1941 when the Gcrmans invaded Greece 
he and his family were evacuated from Greece. He then came to New 
York and resumed his medical practice. At his death he was Chairman 
of the Conference of the obstetrical board at Madison Avenue Hospi- 
tal, assistant attending gynecologist at University Hospital, a member 
of the county, State and national medical societies, and a diplomat of 
the American Board of Obstetrics and Gynecology. He was an author 
of a number of scientific publications in the field of gynecology and a 
designer of instruments used in the field of sterility and for the detec- 
tion of Cancer of the Uterus. For several years he was also the cor- 
responding secretary of the Rudolf Virchow Medical Society. In him 
we lose a very highly esteemed colleague and one of the most efficient 
and conscientious officers of the Society. We were all very shaken by 
his sudden passing and I am sure that it will be difficult to replace him. 
We will all cherish his memory. 



126 



PRESIDENTS OF THE RUDOLF VIRCHOW 

MEDICAL SOCIETY 



*Carl A. Krog . 
*Emil Gruening . 
*Carl A. T. Krog 
*Felix Nordemann 
*Carl Heitzmann 
^Leonard Weber 
*Henry J. Garrigues 
*Abraham Jacobi 
*Carl Heitzmann 
*Joseph W. Gleitsmann 

* Willy Meyer 
*Wolif Freudenthal 
*Herman Klotz . 
*George W. Jacoby 
*Hermann J. Boldt 
*/• 'S- Schmitt 
*Carl Beck . 
*Franz Torek 
*Carl E. Pfeister 
*Gustav Seeligmann 
*Wolß Freudenthal 
*Hermann J. Boldt 

Rudolf Denig . 
*Hermann Fischer 
*Ernst Danziger . 
*Thomas Scholz . 

Carl Eggers 
*Ludwig Oulmann 

Arthur Stein 

Alfred Plaut 

Gerhard L. Moensch 

Paul K. Sauer . 

Robert Muller . 
*George Mannheimer 
^Franz M. Groedel 

Charles Gottlieb 

Rudolf Nissen . 

Joseph Berberich 

Kurt Goldstein . 

Max Jessner 

Herbert Elias 

Paul Hoch . 

* Deceased 



. 1876-1877 

. 1878-1879 

1880-1881 

1882-1883-1884 

1885-1886 

1887-1888 

1888-1890 

1891 

1892 

1893-1894 

1895-1896 

1897-1898 

1899-1900 

1901-1902 

1903-1904 

1905-1906 

. 1907-1908 

1909-1910 

. 1911-1912 

1913-1914 

1915-1916 

1917 

1918-1919-1920 

1921-1922 

1923-1924 

1925-1926 

. 1926-1927 

1928-1929 

1930-1931 

1932-1933 

1934-1935 

1936-1937 

1938-1939 

1940-1941-1942 

1943-1944 

. 1945-1946 

1947 

1948-1949 

1950 

1951 

1952 

1953 



127 



MEMBERS OF THE RUDOLF VIRCHOW 
MEDICAL SOCIETY 

HONORARY MEMBERS 



Casper, Leopold (1945) 

213 West 75th Street, N.Y.C. 
Denig, Rudolf (1897) 

56 East 58th Street, N.Y.C. 
Einhorn, Max ( 1886) 

20 East 63rd Street, N.Y.C. 
Einstein, Albert ( 1941 ) 

Princeton, New Jersey 
Hoeber, Rudolf (1943) 

Philadelphia, Pa. 
Joslin, Elliot (1950) 

81 Bay State Road, Boston, Mass. 
Lieberthal, David (1944) 

104 South Michigan Blvd., 

Chicago, 111. 

Loewi, Otto (1943) 

155 East 93rd Street, N.Y.C. 



MagnuS'Levy, Adolf (1941) 

121 West 105th Street, N.Y.C. 
Meirowsky, Emil (1941) 

1040-1232 West Michigan Street, 

Indianapolis, Ind. 
Neuberg, Carl (1947) 

99 Livingston Avenue, 

Brooklyn, N.Y. 
Nissen, Rudolf (1941) 

Bürgerspital Basel, Schweiz 
Oppenheimer, B.S. (1950) 

124 East eist Street, N.Y.C. 
Pick,Ernest P. (1942) 

19 East 98th Street, N.Y.C. 
Schick, Bela (1925) 

17 East 84th Street, N.Y.C. 
Sondern, Frederick E. (1892) 

180 West 58th Street, N.Y.C. 



CORRESPONDING MEMBERS 



Kleeberg, Julius (1950) 

Hadassah Hospital, Jerusalem, Israel 
Liefmann, Emil (1950) 

105 Grüneburgweg 

Frankfurt a. M., Germany 
Siegrist, Henry A. (1940) 

Casa Serena 

Pura, Ticino, Switzerland 



Thannhauser, Sigfried 

New England Center Hospital, 
Corner Harrison Ave, and 
Benett Street, Boston, Mass. 

Zondek, Bernhard (1950) 
Jerusalem, Israel 



MEMBERS 



Abraham, E. G. (1948) 
993 Park Avenue, N.Y. C. 

Adelsberger, Lucie (1949) 

200 Central Park South, N.Y.C. 

Adler, Alexandra (1946) 
32 East 39th Street, N.Y.C. 

Adler, Louis (1947) 

61 West 74th Street, N.Y.C. 

128 



Adlersberg, D. (1936) 

136 East 64th Street, N.Y.C. 
AI den, Maurice (1946) 

1610 University Ave., Bronx, N.Y. 
Alexander, Hugo ( 1944) 

35-06 94th Street, Jackson Hcights, 

L. I., N.Y. 
Ambinder, Nathan (1949) 

1212Fifth Avenue, N.Y.C. 



Ansfanger, Ludwig Anger (1946) 

35-30 8 Ist Street, Jackson Hcights, 

L.I., N.Y. 
Apton, Adolph N. (1936) 

911 Park Avenue, N.Y.C. 
Aron, Frederick Simon (1946) 

101 West 80th Street, N.Y.C. 
Arons, Isidore (1946) 

57 West 57th Street, N.Y.C. 
Auerbach, Liese (1943) 

155 West 7 Ist Street, N.Y.C. 
Aufricht, Gustave (1927) 

103 East 86th Street, N.Y.C. 
Auslaender, Jacob (1931) 

286 West 86th Street, N.Y.C. 
Bachenheimer, Max (1945) 

398 East 152nd Street, Bronx, N.Y. 
Bader, Edwin (1949) 

42-20 Kissena Boulevard, 

Flushing, L.I., N.Y. 
Baer, Heinrich H. (1952) 

101 West 126th Street, N.Y.C. 
Baer, Richard (1948) 

103 East 86th Street, N.Y.C. 
Ball, Erna (1954) 

87-02 166th Street, Jamaica, N.Y. 
Bamberger, Ernest H. (1927) 

140 West 86th Street, N.Y.C. 
Bardach, Kurt Arthur (1947) 

2 West 88th Street, N.Y.C. 
Bardeleben, Walther (1946) 

645 West End Avenue, N.Y.C. 
Bash, Eric A. (1949) 

28-18 36th Avenue, 

Long Island City, N.Y. 
Batzdorf, Erwin E. (1942) 

865 Park Avenue, N.Y.C. 
Baum, Samuel (1945) 

200 West 58th Street, N.Y.C. 
Beckhard, Erwin (1947) 

87-40 Elmhurst Avenue, 

Elmhurst, L.I., N.Y. 
Behrend,H.J. (1941) 

470 West End Avenue, N.Y.C. 
Behrendt, Hans (1941) 

1165 Park Avenue, N.Y.C. 
Be jach, Hans (1948) 

99 Warren Street, N.Y.C. 
Benfey, Arnold T. (1944) 

50 Park Terrace West, N.Y. C. 
Benjamin, Harry (1918) 

728 Park Avenue, N.Y.C. 



Berberich, Joseph ( 1941 ) 
784 Park Avenue, N.Y.C. 

Berger, W. V. (1942) 

38 East 73rd Street, N.Y.C. 

Bergmann, Ernst W. (1941) 
955 Park Avenue, N.Y.C. 

Bergmann, Fanny (1947) 
41-58 74th Street, 
Jackson Heights, L.I., N.Y. 

Bernstein, Eug. Traugott (1941) 

100 Central Park South, N.Y.C. 

Biber stein, Erna (1951) 

667 Madison Avenue, N.Y.C. 

Biber stein, Hans H. ( 1941 ) 
667 Madison Avenue, N.Y.C. 

Blasi, Anthony Albert (1945) 
25 East Broad Street, 
Mt. Vemon, N.Y. 

Bleyer, Leon 

St. Josephs Hospital 
Providence, R.I. 

Bloch, Rudolf G. (1953) 
5 East 73rd Street, N.Y.C. 

Blum, Joseph (1953) 

106 East 85th Street, N.Y.C. 

Blum, Theodor (1914) 

101 East 79th Street, N.YC. 
Blume, Hans L. W. (1945) 

20 West 77th Street, N.Y.C. 
Blumenthal, Ernest Joseph (1946) 

118-14 83rd Avenue, 

Kew Gardens, L.I., N.Y. 
Boenheim, Flora (1948) 

1175 Park Avenue, N.Y.C. 
Boernstein, Walter (1949) 

4 East 95th Street, N.Y.C. 
Bonis, Alexander (1949) 

145 East 54th Street, N.Y.C. 
Borchardt, Paul Robert (1947) 

2383 Walton Ave., Bronx, N.Y. 
Brandt, Frederick C. (1948) 

57 West 57th Street, N.Y.C. 
Braude, Eugene (1946) 

44 Bennett Avenue, N.Y.C. 
Braun, Martin (1952) 

366 Willis Ave., Bronx, N.Y. 
Breuer, Joshua (1947) 

461 Ft. Washington Avenue, N.Y.C. 
Brinitzer, Hans F. (1940) 

5 West 86th Street, N.Y.C. 



129 



Brodnitz, Friedrich S. (1943) 

667 Madison Avenue, N.Y.C. 
Brunell, Ernst Ludwig (1947) 

35-55 73rd Street, 

Jackson Heights, L.I., N.Y. 
Buchbinder, Selma (1947) 

295 Harvard Avenue, 

Rockville Centre, N.Y. 
Bucky, Gustav (1939) 

5 East 76th Street, N.Y.C. 
Buechler, Erich (1945) 

420 East 86th Street, N.Y.C. 
Burgheim, Fred C. (1939) 

897 Park Avenue, N.Y.C. 
Caan, Paul (1951) 

545 West End Avenue, N.Y.C. 
C aminer, Eric (1944) 

2720 Broadway, N.Y.C. 
Casper, Wolf gang A. (1939) 

25 Central Avenue, 

St. George, Staten Island, N.Y. 
Cohn, Felix (1951) 

215 West 105th Street, N. Y. C. 
Dallas, Arthur (1939) 

200 Central Park South, N.Y.C. 
Dann, Richard (1943) 

37-20 Bist Street, 

Jackson Heights, L.I., N.Y. 
Dessauer, Morris (1946) 

57 West 58th Street, N.Y.C. 
Dessauer, Stephanie (1944) 

1094 Greene Avenue, 

Brooklyn, N.Y. 
Deutschberger, Otto (1949) 

27 West 86th Street, N.Y.C. 
Domarus, Eilhard von (1946) 

865 Park Avenue, N.Y.C. 
Durham, Felix O. (1941) 

829 Park Avenue, N.Y.C. 
Duschak, Ernest T. (1941) 

25 Central Park West, N.Y.C. 
Edkins, Walter E. (1940) 

112-50 78th Avenue, 

Forest Hills, L.I., N.Y. 
Ehrenreich, Max (1941) 

350 East 77th Street, N.Y.C. 
Ehrmann, Rudolf R. (1942) 

568 Park Avenue, N.Y.C. 
Eilbott, Wilhelm (1943) 

755 West End Avenue, N.Y.C. 
Einstein, Fritz I. ( 1951 ) 

570 West 183rd Street, N.Y. C. 



Einstein, Gustav (1939) 

1175 Park Avenue, N.Y.C. 
Elias, Ada (1952) 

433 West End Avenue, N.Y.C. 
Elias, Gunter M. (1948) 

865 West End Avenue, N.Y.C. 
Elias, Herbert (1941) 

21 East 79th Street, N.Y.C. 
Elias, Kurt (1951) 

3455 Steuben Avenue, 

Bronx 67, N.Y.C. 
Eliasberg, Helene (1941) 

65 East 96th Street, N.Y.C. 
Eliasberg, Wladimir (1941) 

151 Central Park West, N.Y.C. 
Eliassow, Alfred (1946) 

83-80 118 Street, 

Kew Gardens, L.I., N.Y. 
Elkan, Wolf (1947) 

120 Central Park South, N.Y.C. 
Eiston, Anny (1949) 

242 East 15th Street, N.Y.C. 
Engel, Hermann (1951) 

1143 Fifth Avenue, N.Y.C. 
Engelmann, Curt (1938) 

667 Madison Avenue, N.Y.C. 
Erlanger, Gustav (1949) 

20 West 77th Street, N.Y.C. 
Fabian, Helen ]. (1945) 

57 West 57th Street, N.Y.C. 
Falkson, Kurt Ferdinand (1951) 

225 West 86th Street, N.Y.C. 
Faltitschek, Josef (1949) 

27 West 72nd Street, N.Y.C. 
Farmer, Laurence (1951) 

993 Park Avenue, N.Y.C. 
Farkas, Aladar (1947) 

133 East 58th Street, N.Y.C. 
Feibes, Henry (1941) 

1855 Monroe Ave., Bronx, N.Y. 
Feigenheimer, Erwin (1949) 

281 Covert Street, Brooklyn, N.Y. 
Felden, Botho F. (1927) 

38 East 85th Street, N.Y.C. 
Ferrington, Elizabeth (1946) 

Laboratory Service 

Veterans Administration Hospital 

Jackson, Mississippi 
Fink, Heinrich Louis (1951) 

2889 Briggs Ave., Bronx, N.Y. 
Fischer, Martin (1951) 

250 West 103rd Street, N.Y.C. 



130 



Fischer, Martin (1953) 
176 Atlantic Avenue, 
Lynbrook, N.Y. 

Flake, Minna Margareta (1947) 
161 West 86th Street, N.Y.C. 

Flehinger, Benno (1945) 

760 West End Avenue, N.Y.C. 
Fliegel, Otto (1951) 

29 West 64th Street, N.Y.C. 
Forchheimer, Ludwig (1949) 

52 East 68th Street, N.Y.C. 
Fraenkel, Kurt F. (1947) 

270 Fort Washington Ave., N.Y.C. 
Frankel, Walter (1949) 

85 Manor Drive, Newark, N. J. 
Frankley, Greta (1947) 

350 Central Park West, N.Y.C. 
Freud, Frederick (1946) 

103 East 86th Street, N.Y.C. 
Freud, Paul (1940) 

106-15 Queens Boulevard, 

Forest Hills, L.I., N.Y. 
Freudenthal, Siegmund (1946) 

230 West 79th Street, N.Y.C. 
Freund, Kate M. (1945) 

115 East 89th Street, N.Y.C. 
Friedemann, Max W. (1944) 

251 Central Park West, N.Y.C. 
Friedman, Geo. Alexander (1947) 

133 East 58th Street, N.Y.C. 
Friedman, Jechiel M. (1949) 

166 Bayard Street, 

Brooklyn 22, N.Y. 

Froeschels, Emil (1941) 

133 East 58th Street, N.Y.C. 

Fryth, Walter B. (1946) 

328 West 86th Street, N.Y.C. 

Fuchs, Bert (1945) 

412 West llOth Street, N.Y.C. 

Fuchs, Felix (1947) 

46 East 80th Street, N.Y.C. 

Gans, Harry (1946) 

141 West 73rd Street, N.Y.C. 

Gerst, Ernst S. (1944) 

34-43 89th Street, 

Jackson Heights, L.I., N.Y. 
Gersuny, Otto (1950) 

625 Park Avenue, N.Y.C. 
Glaubach, Susi (1944) 

520 East 12th Street, N.Y.C. 



Gluck, Annemarie Schmitz (1941) 

1239 Madison Avenue, N.Y.C. 
Gold, Ernest (1943) 

1 1 1 East 80th Street, N.Y.C. 
Goldbloom, Allen A. (1950) 

2 East 95th Street, N.Y.C. 
Goldman, Walter (1941) 

1040 Park Avenue, N.Y. C. 
Goldner, Martin G. (1951) 

327 Central Park West, N.Y.C. 
Goldschmidt, Aron (1939) 

12 East 88th Street, N.Y.C. 
Goldschmidt, Max (1943) 

116 East 63rd Street, N.Y.C. 
Goldschmitt, Solomon (1950) 

333 Central Park West, N.Y.C. 
Goldstein, Eli (1945) 

150 East 94th Street, N.Y.C. 
Goldstein, Kurt (1945) 

1148 Fifth Avenue, N.Y.C. 
Goldzieher, Max (1945) 

104 East 40th Street, N.Y.C. 
Gottlieb, Charles ]. (1940) 

101 East 81st Street, N.Y.C. 
Gottschalk, Nora (1946) 

215 East 164th Street, Bronx, N.Y. 
Gould, Werner (1951) 

219 Passaic Street, Hackensack, N.J. 
Grafenberg, Ernest (1944) 

865 Park Avenue, N.Y.C. 
Graff,HildigardK. (1945) 

314 Parsons Drive 

Syracuse 4, N.Y. 
Graubard, David ]. (1951) 

1082 Park Avenue, N.Y.C. 
Graupner, Frank H. (1945) 

57 West 57th Street, N.Y.C. 
Griesman, Bruno L. (1938) 

47 East 61 Street, N.Y.C. 
Grossmann, Friederick W. (1953) 

20 Sherman Avenue, N.Y. C. 
Grossmann, Herbert O. (1946) 

500 West End Avenue, N.Y.C. 
Gruenthal, Max (1947) 

25 West 8 Ist Street, N.Y.C. 
Gudemann, Joseph (1945) 

567 West 170th Street, N.Y.C. 
Gundelfinger, Ernst (1943) 

152 West 58th Street, N.Y.C. 
Gurewitch, Vladimir (1943) 

1165 Park Avenue, N.Y.C. 



131 



Gutmann, Max (1950) 

1816 Madison Street, 

Brooklyn, N.Y. 
Haas, Alfred (1941) 

143 East 88th Street, N.Y.C. 
Hammerschlag, Ernst ( 1942) 

109 East 81st Street, N.Y.C. 
Hammerschlag, Fred G. (1948) 

247 Cornwall Avenue, 

Valley Stream, L.I., N.Y. 
Handzel, Valerie (1950) 

15 West 84th Street, N.Y.C. 
Hass, Julius (1942) 

17 East 82nd Street, N.Y.C. 
Haymann, Hermann (1951) 

102 East 22nd Street, N.Y.C. 
Hecht, Sigmund (1949) 

47 Arden Street, N.Y.C. 
Heiman, Marcel (1949) 

1148 Fifth Avenue, N.Y.C. 
Heine, Ludwig (1940) 

117-05 84th Ave, Richmond Hill, 

L.I., N.Y. 
Heinemann, Charlotte (1954) 

601 West 174th Street, N.Y.C. 
Heinemann, Walter (1939) 

680 West End Avenue, N.Y.C. 
Heller, William (1941) 

200 Central Park South, N.Y.C. 
Hermann, Franz (1944) 

58 West 90th Street, N.Y.C. 
Hertz, Arthur (1946) 

114 East 54th Street, N.Y.C. 
Hess, Leo (1944) 

210 West lOlst Street, N.Y.C. 
Hesse, Hans (1946) 

412 Audubon Avenue, N.Y.C. 
Heymann, Hans (1941) 

140 West 58th Street, N.Y.C. 
Hirsch, Hans G. (1943) 

333 West End Avenue, N.Y.C. 
Hirsch, Sophie B. Glaser (1949) 

262 Central Park West, N.Y.C. 
Hirschfeld, Hans (1948) 

350 Central Park West, N.Y.C. 
Hirschfeld, Kurt Emil (1946) 

1410 Grand Concourse, Bronx, N.Y. 
Hirschhorn, Max Leo (1951) 

560 1-1 3 th Avenue, Brooklyn, N.Y. 
Hirschowitz, Martin (1947) 

371 Fort Washington Avenue, 

N.Y.C. 
Hoch, Paul (1940) 

1165 Park Avenue, N.Y.C. 

132 



Hochstetter, Werner (1945) 

1 1 East 68th Street, N.Y.C. 
Hoff mann, Karl F. (1926) 

108 East 86th Street, N.Y.C. 
Ho ff mann, Margot (1947) 

1409 Fulton Avenue, Bronx, N.Y. 
Horowitz, Isaac (1943) 

128 Central Park South, N.Y.C. 
Hülse, Wilfred (1938) 

110 West 96th Street, N.Y.C. 
Icken, Ralph, L. (1953) 

25-98, 36th Street, Astoria, L. I. 

N.Y. 

Isaak, Ludwig (1941) 

45 East 85th Street, N.Y.C. 
Isler, Leopold (1947) 

120 West 70th Street, N.Y.C. 
Israel, Arthur (1944) 

155 East 72nd Street, N.Y.C. 
Jacobson, Moritz (1951) 

207 West 106th Street, N. Y. C. 
Jacoby, Max (1948) 

315 Central Park West, N.Y.C. 
Jarecki, Max M. (1947) 

905 Bergh Street, Asbury Park, N.J. 
J essner, Max (1945) 

870 Fifth Avenue, N.Y.C. 

Jolowicz, Ernst (1949) 

147 West 50th Street, N.Y.C. 
Jordan, Henry H. (1946) 

110 East 93rd Street, N.Y.C. 
Julius, Fred Siegfried (1946) 

227 Central Park West, N.Y.C. 
Jüngster, Max (1946) 

320 West 90th Street, N.Y.C. 
Jurasz, Anthony (1953) 

80-20 Broadway, Elmhurst, N.Y. 
Kalinowsky, Lothar B. (1943) 

115 East 82nd Street, N.Y.C. 
Kallmann, Franz (1949) 

959 Madison Avenue, N.Y.C. 
Kaminsky, Anatol (1948) 

433 West 34th Street, N.Y.C. 
Kamnitzer, Siegbert (1946) 

115 West 73rd Street, N.Y.C. 
Kaskel, Ernst (1943) 

520 West llOth Street, N.Y.C. 
Katzenstein, Abraham A. (1948) 

140 West 86th Street, N.Y.C. 
Katzenstein, Margarete H. (1943) 

514 West End Avenue, N.Y.C. 



Kauf er, George (1951) 

771 Seventh Avenue, N.Y.C. 

Kautzky, Karl (1942) 

440 West End Avenue, N.Y.C. 

Kautz, Friedrich G. (1940) 
784 Park Avenue, N.Y.C. 

Kent, Charles (1950) 
80-09 35th Avenue, 
Jackson Heights, L.I., N.Y. 

Kestenbaum, Alfred (1940) 
470 Park Avenue, N.Y.C. 

Kilman, Martin (1949) 

118 East 54th Street, N.Y.C. 

Kirschner, Max (1945) 
109-20 Queens Boulevard, 
Forest Hills, L.I, N.Y. 

Kisch, Bruno (1941) 

845 West End Avenue, N.Y.C. 

Kiwi, Hans S. (1942) 

305 East 88th Street, N.Y.C. 

Klaar, Joseph (1942) 

1239 Madison Avenue, N.Y.C. 
Klaften, Emanuel (1947) 

333 Central Park West, N.Y.C. 
Kleeberg, Ludwig S. (1943) 

2 East 95th Street, N.Y.C. 
Kleemann, Erich Emanuel (1946) 

680 West End Avenue, N.Y.C. 
Klein, George (1943) 

10 East 85th Street, N.Y.C. 
Klein, Martin (1944) 

574 West End Avenue, N.Y.C. 
Klein, Paul (1951) 

46 East 80th Street, N.Y. C. 
Klein, Siegfried B. (1944) 

784 Park Avenue, N.Y.C. 
Klemper er, Edith (1945) 

315 East 77th Street, N.Y.C. 
Klinger, Oskar (1952) 

850 Park Avenue, N.Y.C. 
Kochmann, Alfred (1948) 

667 Madison Avenue, N.Y.C. 
Kolton, Hermann (1941) 

250 West 94th Street, N.Y.C. 
Kornitzer, Ernst (1941) 

1239 Madison Avenue, N.Y.C. 
Krieger, Charles L (1941) 

6 East 85th Street, N.Y.C. 
Kriss, Bruno Reginald (1946) 

970 Park Avenue, N.Y.C. 



Kristeller, Leo (1941) 

20 Seaman Avenue, N.Y.C. 
Kran, Theodor (1946) 

1628 University Avenue, 

Bronx, N.Y. 
Kroner, Jacques (1949) 

333 Central Park West, N.Y.C. 
Kroner, Karl (1948) 

17 Morsemere Place 

Yonkers, N.Y. 
Krueger, Erich (1938) 

Veterans Hospital, 

Kingsbridge Road, Bronx, N.Y. 
Kuhn, Paul H. (1940) 

103 East 75th Street, N.Y.C. 
Kurcer, Mendel (1945) 

85-15 139th Street, 

Jamaica, L.I., N.Y. 
Lange, Hanna S. (1946) 

110-45 Queens Boulevard, 

Forest Hills, L.I., N.Y. 
Lange, Kurt (1942) 

116 Central Park South, N.Y.C. 
Langstadt, Arthur (1946) 

1165 Park Avenue, N.Y.C. 
Lax, Henry (1943) 

160 East 72nd Street, N.Y.C. 
Layton, George A. (1946) 

114 East 54th Street, N.Y.C. 
Lefferts, David (1945) 

230 West 79th Street, N.Y.C. 
Lehfeldt,Hans M. (1945) 

784 Park Avenue, N.Y.C. 
Lehndorff, Heinrich (1941) 

650 Main Street, 

New Rochelle, N.Y. 
Lehr, David (1953) 

Flower Hospital, 

Fifth Avenue and 105th Street, 

New York City 
Leiner, George (1949) 

105 East 74th Street, N.Y.C. 
Leipziger, Hans (1945) 

558 West 164th Street, N.Y.C. 
Lemos, Anita De (1946) 

435 West 119th Street, N.Y.C. 
Lendl, Wilhelmina (1941) 

P.O.B. 706, Rome, N.Y. 
Leopold, Harald (1942) 

9 East 78th Street, N.Y.C. 
Levi, Julius ( 1950) 

140 East 2nd Street, N.Y.C. 



133 



Levi,Max (1948) 

200 Central Park South, N.Y.C. 

Lewi, Maurice J. (1928) 

53 East 124th Street, N.Y.C. 

Lewin, Richard (1944) 

46 Fort Washington Ave., N.Y.C. 

Lewinski, Moritz (1944) 

875 West End Avenue, N.Y.C. 

Lewy, Robert (1945) 
91 Tulip Avenue, 
Floral Park, L.I., N.Y. 

Liehmann, George H. (1946) 
32 West 82nd Street, N.Y.C. 

Lippmann, H. (1942) 

1192 Park Avenue, N.Y.C. 

Lister, Jacob (1947) 

1675 Grd. Concourse, Bronx, N.Y. 

Loewenstein, L. W. (1938) 
125 East 72nd Street, N.Y.C. 

Loewy, Paul (1942) 

440 West End Avenue, N.Y.C. 

Lowenstein, Otto (1941) 
865 Park Avenue, N.Y.C. 

Lowenthal, Adolf (1941) 

230 West 105th Street, N.Y.C. 

Lubliner, Ruth (1952) 
3439 Knox Place, N.Y.C. 

Lussheimer, Paul (1949) 

411 West End Avenue, N.Y.C. 
Lust, Franz J. (1941) 

17 East 89th Street, N.Y.C. 
Maier, Bert ha Spiegel (1946) 

1685 Morris Avenue, Bronx, N.Y. 
Maier, Max (1946) 

216 West 89th Street, N.Y.C. 

Mandelbaum, Recka (1943) 

701 West 175th Street, N.Y.C. 
Mandl, Gustav (1943) 

43-08 41st Street, 

Long Island City, L.I., N.Y. 
Mannheim, Hans L. (1941) 

784 Park Avenue, N.Y.C. 
Marcus, Howard H. (1953) 

200 Central Park South, N.Y.C. 
Mark, Bruno (1944) 

179 East 79th Street, N.Y.C. 
Markham, Paul R. (1941) 

34-20 83rd Street, 

Jackson Heights, L.I., N.Y. 

134 



Markus, Nathan H. (1945) 

50 West 96th Street, N.Y.C. 
Mayer, Ida (1948) 

336 Central Park West, N.Y.C. 
Mayer, Paul J. (1945) 

203 West 90th Street, N.Y.C. 
Mayer, William (1942) 

115 East 116th Street, N.Y.C. 
Meinrath, Hans (1946) 

75-14 Austin Street, 

Forest Hills, L.I., N.Y. 

Metzger, Emy A. (1944) 

1172 Park Avenue, N.Y. C. 
Metzger, Ernst (1939) 

118 East 93rd Street, N.Y.C. 
Meyer, George M. (1945) 

4915 Broadway, N.Y.C. 
Meyer, Max (1942) 

645 West End Avenue, N.Y.C. 
Meyer, Selma (1941) 

84-51 Beverly Road, 

Kew Gardens, L.I., N.Y. 
Miller, Max (1943) 

829 Park Avenue, N.Y.C. 
Mohr, Jacob (1947) 

780 West End Avenue, N.Y.C. 
Moller, Raphael (1946) 

600 West 169th Street, N.Y.C. 
Mosbacher, Emil (1949) 

200 Central Park South, N.Y.C. 
Moser, Hanna Melzer ( 1952) 

844 Carleton Road, Westfield, N.J. 
Moses, Herman (1947) 

262 West 107th Street, N.Y.C. 
Mosse, Carl Emil 

1 38-69 A Jewel Avenue, 

Flushing 67, N.Y. 
Mosse, Eric (1938) 

57 West 57th Street, N.Y.C. 
Muehsam, Edward (1945) 

3 East 74th Street, N.Y.C. 
Mueller,ErnstF. (1935) 

784 Park Avenue, N.Y.C. 
Muller-Deham, Albert (1941) 

243 Riverside Drive, N.Y.C. 
Musa, George (1936) 

50 East 7 Ist Street, N.Y.C. 
Naegele, Alice (1950) 

725 West 184th Street, N.Y.C. 
Nahm, Eric (1941) 

799 Park Avenue, N.Y.C. 



Narath, Peter A. (1939) 

State Road, 

Yorktown Heights, N.Y. 
Nathan, Ernest (1941) 

133 East 58th Street, N.Y.C. 
Nathan, Helmuth (1938) 

667 Madison Avenue, N.Y.C. 
Nathorff,Eric (1941) 

30 West 70th Street, N.Y.C. 
Nauenberg, Erna de (1951) 

1107 Fifth Avenue, N.Y. C. 
Neub erger, Siegfried (1946) 

590 Bedford Avenue, Brooklyn, N.Y. 
Neuburger, Joseph (1950) 

542 West 112th Street, N.Y.C. 
Neugarten, Ludwig (1934) 

952 Fifth Avenue, N.Y.C. 
Neuhaus, Fritz (1945) 

715 West 175th Street, N.Y.C. 
Neumann, Edith A. (1944) 

83-44 Lefferts Boulevard, 

Kew Gardens, L.I., N.Y. 
Neumann, Gottfried (1950) 

950 Park Avenue, N.Y.C. 
Neumann, Rudolf (1948) 

83-44 Lefferts Boulevard, 

Kew Gardens, L.I., N.Y. 
Neustadt, Adolph (1946) 

3900 Greystone Ave., Bronx, N.Y. 
New, Arthur (1944) 

129 West llOth Street, N.Y.C. 
Niemann, Walter (1930) 

Jericho Turnpike, Hillside Boulev., 

New Hyde Park, N.Y. 
Norris, Paul F. (1953) 

37-32 79th Street, 

Jackson Heights, L.L, N.Y. 
Novak, Josef (1945) 

865 Park Ave., N.Y.C. 
Nussbaum, William (1949) 

82-31 Austin Street, 

Kew Gardens, L.L, N.Y. 
Ochs, Isaak Julius (1946) 

215 West 98th Street, N.Y.C. 
Offenbacher, Richard (1949) 

13 20-5 Ist Street, Brooklyn, N.Y. 
Olnink,Ignatius Nie. W. (1942) 

435 East 57th Street, N.Y.C. 
Oppenheim, Henry (1947) 

41-96 Gleane Street, 

Elmhurst, L.L, N.Y. 
Oppenheimer, Helmuth Ernst (1946) 

865 Park Avenue, N.Y.C. 



Ottenheimer, Lilly C. (1945) 
36 East 68th Street, N.Y.C. 

Ottenheimer, Julius G. (1945) 
114 East84th Street, N.Y.C. 

Palmer, Herbert J. (1944) 
170 East 77th Street, N.Y.C. 

Paltauf, Rudolf (1935) 

344 West 72nd Street, N.Y.C. 

Pasch kis, Rudolf (1942) 

133 East 58th Street, N.Y.C. 

Peller, Sigismund (1949) 
164 East 81st Street, N.Y.C. 

Perez, Willy M. (1939) 

57 West 57th Street, N.Y.C. 

Perls, Walter L. (1945) 

525 West End Avenue, N.Y.C. 
Pflaum, Alfred (1947) 

225 West 7 Ist Street, N.Y.C. 
Pick, Paul (1952) 

983 Park Avenue, N.Y.C. 
Pineas, Herman O. (1949) 

1225 Park Avenue, N.Y.C. 
Pollak, Richard (1946) 

27 West 72nd Street, N.Y.C. 
Preminger, Max ( 1944) 

Pemberton Road, New Lisbon, N.J. 

Prihram, Bruno O. C. (1947) 

910 Fifth Avenue, N.Y.C. 
Proskauer, Arthur (1948) 

69-40 108th Street, 

Forest Hills, L. L, N.Y. 
Rachmann, Walter (1946) 

200 Bennett Avenue, N.Y.C. 
Rapp, Menny (1940) 

515 West End Avenue, N.Y.C. 
Reis, Julius (1946) 

245 Fort Washington Ave., N.Y.C. 
Reissner, Albert (1943) 

93 Eighth Avenue, 

Brooklyn, N.Y. 
Riesenfeld, Fritz D. (1947) 

50 West 72nd Street, N.Y.C. 
Robbins, Sidney (1947) 

30 East 60th Street, N.Y.C. 
Roos, Nathan (1946) 

454 Fort Washington Ave., N.Y.C. 
Rosenbaum, Ernst (1945) 

5 West 86th Street, N.Y.C. 
Rosenberg, Arthur (1945) 

238 Fort Washington Ave., N.Y.C. 



135 



Rosenberg, Dora (1946) 

53-75 65th Place, Maspeth, N.Y. 
Roseno, Alfred (1940) 

950 Park Avenue, N.Y.C. 
Rosenow, Anna (1946) 

371 Fort Washington Ave., N.Y.C. 
Rosenow, George (1943) 

944 Fifth Avenue, N.Y.C. 
Ross, Alfred (1940) 

20-35 Seagist Avenue, 

Far Rockaway, L. I., N.Y. 
Rothmann, Eva (1947) 

1 148 Fifth Avenue, N.Y.C. 
Rubin, I.e. (1940) 

911 Park Avenue, N.Y.C. 
Sachs, Henry B. (1948) 

145 Vermilyea Avenue, N.Y.C. 
Sachs, Louis (1941) 

1 16 East 58th Street, N.Y.C. 
Saiten, Rudolf (1942) 

955 Park Avenue, N.Y.C. 
Samson, Joseph W. (1944) 

775 Riverside Drive, N.Y.C. 
Samuel, Arthur (1944) 

12 Dongan Place, N.Y.C. 
Samuels, Saul (1948) 

151 East 83rd Street, N.Y.C. 
Sand, Herman (1951) 

1158 Boynton Ave., Bronx, N.Y. 
Schachter, Franz (1947) 

963 Avenue St. John, Bronx, N.Y. 
Schaefer, Erich (1944) 

53 Main Street, Canton, N.Y. 
Schalscha, Kurt (1952) 

667 Madison Avenue, N.Y.C. 
Schauder, Herman (1947) 

4 East 95th Street, N.Y.C. 

Scheyer, Hans E. (1945) 

61 Elm Street, Potsdam, N.Y. 
Schindler, Richard (1942) 

360 Central Park Ave., N.Y.C. 
Schlesinger, Benno (1944) 

108 West 85th Street, N.Y.C. 
Schmidt, Robert M. (1943) 

108-24 7 Ist Street, Forest Hills, 

L.L, N.Y. 
Schnebel, Emil (1942) 

103 Thayer Street, N.Y.C. 
Schnerb, Godschau (1947) 

717 West 177th Street, N.Y.C. 
Schoenfeld, Siegfried (1939) 

200 Central Park South, N.Y.C. 

136 



Schomberg, Ernest (1950) 

466 West 13 Ist Street, N.Y.C. 

Schwarz, Eugene E. (1952) 

65 East 76th Street, N.Y.C. 
Schwarz, Gottwald (1949) 

63 East 84th Street, N.Y.C. 
Schwarzbart, Irma Julia (1946) 

110-35 72nd Avenue 

Forest Hills, L.L, N.Y. 
Schwarzmann, Emil (1942) 

133 East 58th Street, N.Y.C. 
Schwarzschild, Ludwig (1947) 

514 West End Avenue, N.Y.C. 
Schweitzer, Ernst E. (1953) 

133 East 40th Street, N.Y.C. 
Seidemann, Herta (1951) 

1349 Lexington Ave., N.Y.C. 
Seidenberg, Leopold (1941) 

200 Central Park South, N.Y.C. 
Selig, Rudolf (1941) 

56 East 87th Street, N.Y.C. 
Seligmann, Fred S. (1948) 

501 32nd Street, Union City, N.J. 
Senator, Hans (1941) 

115-55 77th Avenue, 

Forest Hills, L.L, N.Y. 

Sichell, Jane (1952) 

666 West End Avenue, N.Y.C. 
Sichell, Max Josef (1946) 

666 West End Avenue, N.Y.C. 
Siegel, Erich (1942) 

151 West 86th Street, N.Y.C. 
Sielman, Hans R. (1941) 

105 East 74th Street, N.Y.C. 
Silbermann, Maximilian (1948) 

893 Park Avenue, N.Y.C. 
Simon, Arthur F. (1939) 

86-10 34th Avenue, 

Jackson Heights, L.L, N.Y. 
Simon, Eugene (1949) 

315 West 106th Street, N.Y.C. 
Singer, Rudolf (1941) 

1100 Park Avenue, N.Y.C. 

Sonnenfeld, Anni (1951) 

116 East 58th Street, N.Y.C. 
Sonnenfeld, Arthur (1944) 

116 East 58th Street, N.Y.C. 
Spaeth, Kurth (1944) 

562 West 148th Street, N.Y.C. 

Stein, George (1952) 

730 Fifth Avenue, N.Y.C. 



Steinhardt, Max (1946) 

2980 Valentine Avenue, 

Bronx, N.Y. 
Stern, Rudolf A. (1941) 

1150 Fifth Avenue, N.Y.C. 
Sternberg, Adolph S. (1947) 

853 Seventh Avenue, N.Y.C. 
Stone, Paul (1947) 

47-02 Skillman Avenue, 

Long Island City, L.L, N.Y. 
Strauss, Elizabeth (1945) 

315 Central Park West, N.Y.C. 
Strauss, Hans (1940) 

315 Central Park West, N.Y.C. 
Sulzberger, Marion B. (1931) 

999 Fifth Avenue, N.Y.C. 
Sundheimer, Martin (1951) 

70 Cortlandt Ave., New Rochelle, 

N.Y. 
Swienty, Wilhelm (1947) 

50 West 72nd Street, N.Y.C. 
Tater ka, Henry M. (1947) 

325 West End Avenue, N.Y.C. 
Teichner, Herbert (1951) 

195 Genesee Street, Geneva, N.Y. 
Teleky, Ludwig (1948) 

96 Wadsworth Terrace, N.Y.C. 
Torner, Joseph (1944) 

402 Clinton Avenue, Albany, N.Y. 
Trautman, Edgar (1941) 

57 East 88th Street, N.Y.C. 
Trefousse, George L. (1947) 

241 Central Park West, N.Y.C. 
Tr eitel, Emil (1944) 

57-26 6 Ist Street, Maspeth, N.Y. 
Tuch, Richard (1949) 

189 Sherman Avenue, N.Y.C. 
Ullman, Walther Hans (1951) 

115 West 86th Street, N.Y.C. 
Ulrich, Oscar (1939) 

27 West 86th Street, N.Y.C. 
Violin, Edward (1950) 

57 East 88th Street, N.Y.C. 
Vogl, Alfred (1942) 

1165 Park Avenue, N.Y.C. 
Vollmer, Hermann (1939) 

25 Central Park West, N.Y.C. 
Wachen, Robert (1947) 

60-52 Palmetto Street, 

Ridgewood, L.L, N.Y. 



Wachstein, Max (1952) 

St. Catherines Hospital, 

Brooklyn, N.Y. 
Wagner, Martin (1950) 

215 West 88th Street, N.Y.C. 
Wahl, Stephen (1948) 

14 East 90th Street, N.Y.C. 
Waitzf eider, Walter (1952) 

229 West 78th Street, N.Y.C. 
Waltuch, Max (1949) 

119 East 84th Street, N.Y.C. 
Weichsel, Manfred (1947) 

47-07 41st Street, 

Sunnyside, L.L, N.Y. 
Weil, Rudolf (1944) 

230 Central Park South, N.Y.C. 
Weinberg, Frederick S. (1942) 

375 Riverside Drive, N.Y.C. 
Weiner, Ernst B. (1942) 

133 East 58th Street, N.Y.C. 
Weisenbeck, Max (1943) 

East Avenue, Onondage Hill, N.Y. 
Weiss, Frederick A. (1943) 

1 1 Riverside Drive, N.Y.C. 
Weiss, Harry (1946) 

75 Fort Washington Avenue, N.Y.C. 
Weiss, Herrman (1944) 

300 Madison Ave., Madison, N.J. 
Weiss, Samuel (1917) 

146 Central Park West, N.Y.C. 
Wendel, Gustav (1946) 

43-10 44th Street, 

Long Island, L.L, N.Y. 
Wertheim, Frederick Max ( 1946) 

143 West 96th Street, N.Y.C. 
Winkler, Günther E. (1948) 

30 Central Park South, N.Y.C. 
Wolf, Max (1941) 

969 Park Avenue, N.Y.C. 
Wolf, Günther E. (1944) 

Box A 241, Camarillo, Calif. 
Wolfsen, Martin Richard (1947) 

65 Central Park West, N.Y.C. 
Zak, Frederick Gerard (1951) 

25 East 94th Street, N.Y.C. 
Ziegler, Joseph (1950) 

510 Madison Avenue, N.Y.C. 
Zinner, Alfred (1944) 

17 East 82nd Street, N.Y.C. 



137 



ASSOCIATE MEMBERS 



Molitor, Hans (1936) 

Merck Institute, Rahway, N.J. 



Schleger, Fred (1942) 

108 East 79th Street, N.Y.C. 



INACTIVE MEMBERS 



Alexander, Berthold 

Mt. Sinai Hospital, Chicago 8, 111. 
Colmers, Franz A. (1938) 

3 East 74th Street, N.Y. C. 
Feldstein, Zama (1913) 

62 West 82nd Street, N.Y.C. 
Fuld, Ernest M. (1951) 

1125 Grand Concourse, Bronx, N. Y. 
Glas, Emil 

101 East 74th Street, N.Y.C. 
Gordon, Irving (1945) 

200 West 20th Street, N.Y.C. 
Kreuder, Henry (1902) 

635 Riverside Drive, N.Y. C. 
Kruna, Richard 5. ( 1 94 1 ) 

50 North Broadway, 

White Plains, N.Y. 
Kutner, Reynold (1949) 

47 Fort Washington Ave., N.Y. 
Mannheimer, Jacob (1941) 

1125 Grand Concourse, Bronx N Y 
Plaut, Alfred (1929) 

Armed Forces Institute 

of Pathology, Washington, D.C. 



138 



Prinz, Leopold (1949) 

143 West 96th Street, N.Y.C. 
Schapiro, Bernard 

Jerusalem, Israel 

Seligmann, Albert (1946) 
41 Forest Avenue, 
Silverlake, L.I., N.Y. 

Sellings, William (1942) 

837 N. La Jolla Avenue, 

Los Angeles, Calif. 
Steffens, William (1894) 

300 Convent Avenue, N.Y.C. 
Strauss,Max (1941) 

200 Central Park South, 

New York City 

Wiener, Joseph Charles (1946) 
84-09 Talbot Street, 
Kew Gardens, L.I., N.Y. 

Wolf, Heinrich 
85 Fifth Ave., N.Y.C. 

Zuerndorf er, Louis (1952) 

915 Brückner Blvd. Bronx, N.Y. 



ATLAS DER SYSTEMATISCHEN 

ANATOMIE DES MENSCHEN 

VON PROF. DR. MED. ET PHIL. 

GERHARD WOLF-HEIDEGGER 

BASEL 



Band 1 Skeletsystem-Knochenverbindungcn- Muskulatur 

IV -f- 218 S.. 347 gröfiteils mehrfarb. Abb., 1944, sFr. 32.— 

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Jeder Band enthält ca. 350 mehrfarbige Abbildungen auf ca. 250 Seiten. 

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beliebigen Lehrbuch verwendet werden kann. 
Verlangen Sie den Spezialprospekt mit Probetafeln. 

Aus den ersten Urteilen: 

«...Was den neuen Atlas von G. Wolf- Heidegger betrifft, so kann ich wohl sagen, 
dafi die Abbildungen ausgezeichnet sind, und ich selbstverständlich gerne meinen 
Studenten diesen mich sehr interessierenden Atlas empfehlen werde...» W. K. 
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«... I was tremendously impressed with the excellence of the plates, the remark- 
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recommend this book very highly to my students and professional confreres...» 

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«... Un coup d*OBil aux 6dbantillons des illustrations que vous avez unis k votre 
lettre suffit pour se rendre compte du soin avec lequel les pr^parations ont htk 
cboisies et les fignres exdcut^es; la valeur didactique de votre oeuvre est hors 
de discussion ...» R. A 



BASEL (Schweiz) 



S. KARGER 



NEW YORK 



The Journal of the American Medical Profession 






Ky- 



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a' 



K/ 



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Mechanotherapy of Impotene 
Artificiai Inseminatio 
After Effects of Impotene 

Obesity 
Sociaiization in Britain 
From the Secretary of Defense 




Medical Book News 
Contemporary Progress 



Editorlols 
Contents Pages 7a, 9a 



Vol. 77 



May 1949 



No. 5 



I 

^ 



of nausea and vomiting while taking 
dienestrol; this occurred on a dosage of 
0.5 mg. daily; after stopping treatment for 
a week, it was begun again with a dosage 
of 0.3 mg. daily without further signs 
of toxicity. Only 2 patients had with- 
drawal bleeding; one of these was a cas- 
trate twenty-seven years of age, who had 
shown withdrawal bleeding with other 
types of estrogen therapy. By giving 
dienestrol in intermittent courses of twenty 
days with ten-day intervals, withdrawal 
bleeding simulating normal menstrual 
periods was obtained. The other patient 
was sixty-three years of age and showed 
slight bleedmg (Spotting) for a day after 
voluntarily discontinuing treatment for a 
week. 

COMMENT 

Judging front the author's clinical evalua- 
tion dienestrol is "just another" estrogenic 
hormone. We have had no expertence with 
this particular hormone but apparently it is 
potent (even when taken by mouth) and has 
yery jew side effects. Given a potent prepara- 
tion that can be given by mouth there is 
little choice in the muUitude of estrogenic 
hormones available. H.B.M, 

Vaginal Cytology of Postmeno- 
pausal Women 

J. R. Kernodle and W. K. Cuyler 
(Southern Medical Journal, 41:861, 869, 
Oct. 1948) report a study of the cytology 
of 415 sets of vaginal and cervical smears 
from postmenopausal women-; 70 of these 
smears came from women with malig- 
nant lesions of the genital organs. These 
smears were classified according to Papani- 
colaou and Traut with several Subtypes 
created by the authors to define the cytology 
more acurately. One of the Subtypes, 
AMA (atrophic menopause, acidophilic), 
has been the subject of a special study. 
In the group of 257 patients without 
malignant lesions, the average age was 
53.2 years; the menopause was spontaneous 
in 207 cases, and surgical in 50 cases; 
68 patients had had postmenopausal 
bleeding. Type II smears (atypical epithe- 
lial cells, but not malignant) were 
found in 80.5 per cent of the patients. 

238 



Repeat smears were made in some cases 
(a total of 345 smears); in these smears, 
subtype R (regressive) was most fre- 
quently found.' Trichomonas vaginalis 
was associated most frequently with sub- 
type R. Chronic Cervicitis was present m 
more than one-third of the patients and 
was associated most frequently with Sub- 
types R and AMA. In the malignant 
group, subtype R was associated most fre- 
quently with malignancy, and subtype 
AMA was least frequently found. A 
special study of subtype AMA was made 
in the vaginal smears of 68 post-meno- 
pausal women. These smears show various 
types of basal cells, including normal basal 
cells, but all are acidophilic, most of the 
cells' are smaller than normal, and some 
show various stages of necrocytosis. These 
smears were not frequently associated 
with malignancy. They represent an "ac- 
centuated degeneration," which is prob- 
ably secondary to an endogenous hormonal 
imbalance; although sometimes associated 
with infection, infection was not present 
in the majority of cases showing this type 
of smear. 

Com ME NT 

Vaginal cytology in postmenopausal jvomen 
is destined to become a routine procedure. 
Indeed, it may be said to be "just that" right 
nojv. Any such patient coming to the ofßce 
for a general check-up has not had a cornplete 
examination unless vaginal cytology is in- 
cluded. The authors have classified smears 
according to Papanicolaou and Trout and 
have created, for the sake of accuracy, several 
Subtypes. At least two of these Subtypes have 
received special study. One could be definitely 
said to be non-malignant, whereas the other 
was just as surely malignant. If you are in- 
terested in vaginal cytology read this article 
— yes, study it. Remember! early diagnosis is 
still the only hope for a positive eure of 
Cancer. H.B.M. 

The Treatment of Uterine Fibroids 

F. L. Payne (Surgical Clinics of North 
America, Dec. 1948:1455) states that since 
uterine fibroids may give rise to no Symp- 
toms and have "a very low potential" for 
malignant degeneration, a diagnosis of 
uterine myoma is not necessarily an indi- 
cation for active treatment. If a diagnosis 
of a fibroid tumor is definitely established 

MEDICAL TIMES, MAY. 1949 



in a woman approaching the menopause, 
the patient is kept under Observation with- 
out treatment as long as there are no 
Symptoms and the tumor does not exceed 
the size of a three months' pre.cnancy. 
The same is true of a woman "past the 
menopause, if the tumor is small and there 
are no Symptoms; such women should be 
Seen at least every six months, and treat- 
ment instituted if pain or bleeding devel- 
ops. Some younger women with very small 
hbroids may also be kept under Observa- 
tion if they desire to have a child prior 
to surgical treatment. In some patients 
approaching the menopause, who have a 
small uterine fibroid, with menorrhagia 
the only Symptom, androgen therapy is of 
value to control the bleeding; androgen 
therapy must be used with care in order 
to avoid untoward reactions. It may also be 
used occasionally in younger women with 
small fibroids who wish to defer Opera- 
tion for a time. Radium has been used 
in the treatment of uterine fibroids in the 
author's clinic since 1912; and has been 
found to be indicated in about 20 per 
cent of cases. It is used chiefly in women 
approaching the menopause, who have rela- 
tively small uterine fibroids with abnormal 
bleeding; after a diagnostic curettage an 
intrauterine application of a menopausal 
dose of radium is given. It is also em- 
ployed occasionally in younger women 
with abnormal bleeding and small uterine 
fibroids; in some of these cases Operation 
can be deferred, and in others, the ab- 
normal bleeding is controlled without Op- 
eration. X-ray therapy may be used for 
the control of bleeding when radium or 
immediate Operation is contraindicated; in 
some cases marked regression of the tumor 
results. Myomectomy is indicated in 
about 10 to 15 per cent of cases of uter- 
ine fibroids, chiefly in young women in 
the childbearing period. Hysterectomy is 
the Operation of choice in most cases of 
uterine fibroids. Vaginal hysterectomy is 
done only when the uterus is slightly en- 
larged and there is no adnexal disease. 
Abdominal hysterectomy is usually the 
method of choice; the author does not per- 
form total hysterectomy routinely, but 
prefers it to supravaginal hysterectomy if 

MEDICAL TIMES, MAY. 1949 



the general condition of the patient per- 
mits and benign cervical disease is present. 
Any healthy ovarian tissue is conserved. 

COMMENT 

IVe have taught and practiced for many 
years that "all fibroids need to be watched 
but not all fibroids need to be treated." We 
have "watched" fibroids that gave no clinical 
Symptoms and did not suddenly change in 
stze, consistency or sensitivity (5-10 years or 
longer) before instituting active treatment. 
Of course, the size and multiplicity of fibroids 
are always important. We can see no härm 
m such management and in not a few cases 
great good is accomplished by preserving the 
childbearing (also the menstrual) function 
as long as it is feasible to do so. As the author 
States, fibroids have "a very low potential" 
for malignant changes and if under constant 
conttnuous Observation (peivic examination 
every 3-6 months, more often if indicated) 
there is very little risk from this angle of the 
Problem, We can agree 100 per cent with 
the plan of active treatment that the author 
advocates. It is conservative, withoui too much 
risk to the patient, and it is reasonable, par- 
ttcularly if the patient is in the childbearing 
age and is married or expects to get married. 
It requires more "guts" to be intelligently 
conservative than it does to be immediately 
radtcal. H.B.M. 

Cervical Obturation with Inflatabie 
Cannuia in Uterotubal InsufRation 
and Hysterosalpingograpiiy 

I. C. Rubin and Ernest Myller (Amer- 
ican Journal of Obstetrics and Gynecology, 
56:1077, Dec. 1948) describe a cannuia 
with an inflatabie rubber bulb used for 
obturation of the cervical canal during 
uterotubal insufl^ation or hysterosalpin- 
gography. This instrument can be in- 
serted into any cervical canal that admits 
a uterine sound. The rubber bulb can be 
inflated with an aqueous contrast medium, 
so that the relation of the bulb to the 
cervical canal can be demonstrated. The 
advantages of this type of cannuia are: 
It provides airtight closure of the cervical 
canal, which is essential for either utero- 
tubal insufflation or hysterosalpingography ; 
its application is painless and it causes no 
trauma; it maintains the normal anatomi- 
cal Position of the uterus. Another ad- 
vantage of this cannuia is that the pressure 

239 



within the rubber bulb determines the 
maximum pressure that can be used for 
tubal insufflation or hysterosalpingography, 
for if the pressure used in either of these 
procedures exceeds that in the rubber bulb, 
there is prompt escape of the gas or the 
opaque medium from the cervix. Thus the 
rubber bulb of the cannula acts as "a 
desirable safety valve" which prevents un- 
due mcrease of pressure within the uterus. 

Com ME NT 
Everybody who has ever done the Rubin 



test for patency of the fallopian tubes or 
hysterosalpingography knows that cervical 
obturation is of major importance. Regurgita- 
tion of CO2 gas or oil leads to failure of these 
tests, The authors have derised a cannula 
with an inflatable bulb which can be inflated 
after passage through the cervical canal into 
the uterine cavity and by downward traction 
affords an affective means of plugging the 
internal cervical os, It works. We have had 
no personal experience but have seen Dr. 
Rubin demonstrate this cannula and it cer- 
tainly has every advantage over all other 
methods of cervical obturation that we know 
about. If you perform the Rubin test get one 
of these cannulas. You will never regret it. 



OBSTETRICS 



Rh Sensitization in a Primipara 
Caused by Intramuscular 
Injection of Human Serum 

J. Thornton Wallace and associates 
(American Journal of Obstetrics and Gyne- 
cology, 56:1163, Dec. 1948) report a 
case in which an Rh-negative woman in 
her first pregnancy showed Rh antibodies 
in the serum from the seventh week of 
pregnancy, which suddenly rose to a high 
titer in the thirty-second week. The hus- 
band was Rh-positive, and presumably 
heterozygous for the Rh factor. In this 
case there was no history of blood trans- 
fusions or injections of whole blood at 
any time in the patient's life, but there 
was a history of intramuscular injections 
of pooled adult serum as a prophylactic 
measure against poliomyelitis when the pa- 
tient was eight years of age. At the time 
when the Rh antibody titer rose suddenly, 
a cesarean section was done in the hope 
of preventing severe erythroblastosis fetalis 
in the infant. Although an exchange 
transfusion was begun shortly after birth, 
the infant died on the second day; autopsy 
showed the typical pathological changes 
of erythroblastosis fetalis. The mother 
made a good recovery, but experience in 
similar cases indicates that it is doubtful 
if the Rh antibody in her serum will fall 
sufficiently to enable her to have a viable 
Rh-positive infant. As the husband is 
heterozygous, there is a possibility of an 

240 



Rh-negative infant which would not be 
erythroblastotic. It is now generally recog- 
nized that transfusions or even intra- 
muscular injections of Rh-positive blood in 
Rh-negative individuals cause Rh sensitiza- 
tion more frequently than pregnancy with 
Rh-positive fetuses. This case shows that 
the injection of serum or plasma into Rh- 
negative women may also cause Rh sensi- 
tization, and that careful inquiry should be 
made in regard to such injections in taking 
the obstetric histories of Rh-negative 
women. 

COMMENT 

The authors report a case of Rh sensitiza- 
tion in a Primipara caused by the intra- 
muscular injection of human serum years 
previously. This case report, among other 
things, brings out three points that should 
always be kept in mind by the accoucheur, 
viz^: (1) that cesarean section performed some 
weeks before term may not keep the baby 
from dying of erythroblastosis: (2) that an 
exchange transfusion does not always save an 
erythroblastotic baby; and (3) that the mere 
injection of serum or plasma into Rh-negative 
women may cause Rh sensitization and that a 
careful inquiry into the past history regarding 
injections and/or transfusions should always 
be undertaken. Take warning and "save face" 
when handling Rh-negative women, H.B.M. 

The Treatment of Eclampsia by 
Means of Regional Nerve Block 

F. E. Whitacre and associates (Southern 
Medical Journal, 41:920, Oct. 1948) re- 

MEDICAL TIMES, MAY. 1949 



port that they nave used regional nerve 
block in the treatment of their most se- 
vere cases of eclampsia with good results. 
Restlessness is controlled with the sedative 
drugs commonly used; and hypertonic in- 
travenous glucose is given, in addition 
to the regional nerve block. In the typical 
case reported, 8 cc. of "metycaine" in 1.5 
per Cent Solution was first introduced into 
the sacral canal; as this produced no evi- 
dence of spinal anesthesia, an initial dose 
of 22 cc. of the "metycaine" Solution was 
given and a segmental level of cutaneous 
anesthesia was maintained between thoracic 
8 and 10, by giving 20 cc. of the "mety- 
caine" Solution every forty-five minutes. 
The blood pressure feil gradually. The 
regional nerve block was maintained and 
the blood pressure controlled for thirty- 
six hours, during which time a few uterine 
.contractions occurred. As it became in- 
creasingly difficult to maintain the regional 
nerve block, labor was induced by artificial 
rupture of the membranes, and a satisfac- 
tory nerve block to control hypertension 
and to relieve the pain of labor was main- 
tained by introducing the "metycaine" So- 
lution into the subarachnoid Space, above 
the third lumbar interspace, in a dosagc 
of 1 to 2 cc. every hour. The nerve block 
was continued for twenty-four hours after 
deljvery, and there was no rise in blood 
pressure. Both the mother and her in- 
fant were discharged in good condition. 
Recently, in cases in which regional nerve 
block has been used to control blood 
pressure and increase the urine volume, 
intravenous injection of mannitol in dis- 
tilled water has been employed every four 
hours, in addition to 5 to 10 per cent glu- 
cose Solution, as necessary to produce effec- 
tive diuresis and dehydration. 



COMMENT 

We, of course, have no specific treatment 
for the toxemias of pregnancy, including 
eclampsia. Therefore any adjunct to the com- 
monly employed treatment of eclampsia ts 
acceptabte. The one case reportd by the 
authors naturally does not establish the trust- 
worthiness of regional nerve block. On the 
other hand, the %asic principles involved are 
sound and, under proper auspices, this method 
should prove of very great value. We have 

MEDICAL TIMES, MAY, 1949 



not personally employed the method but can 
see no reason for not using regional nerve 
block if the occasion arises. Go ahead and 
try it! Be sure you know the technic or, better 
still, have a qualified anesthetist per form the 
f^iock. H.B.M. 

Decidual Bleeding in Pregnancy 

H. A. Power (Atnerican Journal of Ob- 
stetrics and Gynecology, 56:743, Oct. 
1948) reports 13 cases in which vaginal 
bleeding ocairred in the first four and 
one-half to five months of pregnancy and 
was not due to premature Separation or low 
Implantation of the placenta. The bleed- 
ing varied in amount, and in 4 cases was 
accompanied by cramps; all of these 4 
patients abortcd four to six weeks after 
the onset of Symptoms, but in one in- 
stance the child was viable (seven months) 
and survived. In the other 9 cases the 
bleeding ceased and the pregnancy pro- 
gressed to term or near term and all the 
infants survived. One of the patients was 
fully ambulatory, 5 were on bcd rest, and 
7 were kept in bed and given estrogen 
and progesterone therapy. In all cases, 
areas of decidual degeneration were found 
after delivery, the degeneration being most 
extensive in those cases in which preg- 
nancy terminated early. No evidence of 
subplacental hematoma or of gross patho- 
logical changes in the placenta was found 
in any case. In one case there was an 
apparent cervical polyp, which was found 
to consist of degenerated decidua. These 
findings indicate that bleeding in early 
pregnancy may result from degeneratin^ 
decidual tissue; in such cases, the bleed- 
ing gradually ceases, as a rule, and preg- 
nancy progresses normally under con- 
servative treatment; the value of endocrine 
therapy was not dearly demonstrated in 
this series. The final diagnosis depends 
upon examination of any tissue passed 
and inspection of the placenta and mem- 
branes following delivery. 

COMMFNT . 

Decidual bleeding in pregnancy is a real 
pathological entity. Clinically the diagnosis 
is difficult to make. Micro scopically it is easy. 
Not infrequently a diagnosis of threatened or 

241 



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AMERICAN JOURNAL 



OF 



OBSTETRICS AND 
GYNECOLOGY 



Vol. 56 



December, 1948 



No. 6 



Editor 
GEORGE W. KOSMAK 

Associate Editors 
HOWARD C. TAYLOR, JR. WILLIAM J. DIECKMANN 



OFFICIAL ORGAN 



THU AMERICAN GYNECOLOGICAL SOCIETY 
THE AMERICAN ASSOCIATION OF OBSTETRICIANS, GYNECOLOGISTS, 

AND ABDOMINAL SURGKONS 

NEW YORK OBSTETRICAL SOCIETY; OBSTETRICAL SOCIETY OF PHILADELPHIA 

BROOKLYN GYNECOLOGICAL SOCIETY; ST. LOUIS GYNECOLOGICAL SOCIETY 

NEW ORLEANS GYNECOLOGICAL AND OBSTETRK^AL SOCIETY 

BALTIMORE ^i^STETRICAL AND GYNECOLOGICAL SOCIETY 

CHICAGO GYNECOLOGICAL SOCIETY; CINCINNATI OBSTETRIC SOCIETY 

CENTRAL ASSOCIATION OF OBSTETRICIANS AND GYNE(X)L()GJSTS 

AMERICAN BOARD OF OBSTETRICS AND GYNECOLOGY 

WAHINGTON GYNECOLOGICAL SOCIETY 

PITTSBURGH OBSTETRICAL AND GYNECOLOGICAL SOCIETY 

OBSTETRICAL SOCIETY OF BOSTON 

LOUISVILLE OBSTETRICAL AND GYNECOLOGICAL SOCIETY 

SOUTH ATLANTIC ASSOCIATION OF OBSTETRICIANS AND (}YNECOLO(JlSTS 

SEATTLE GYNECOLOGICAL SOCIETY 

SOCIETY OF OBSTETRICIANS AND GYNECOLOGISTS OF CANADA 

ALABAMA ASSOCIATION OF OBSTETRICIANS AND GYNECOLOGISTS 

AKRON OBSTETRICAL AND GYNECOLOGICAL SOCIETY 

KANSAS CITY OBSTETRICAL AND GYNECOLOGICAL SOCIETY 

CENTRAL NEW YORK ASSOCIATION OF GYNECOLOGISTS AND OBSTETRICIANS 

NEW JERSEY OBSTETRICAL AND GYNECOLOGICAL SOCIETY 



PUBLISHED BT THE C. V. MOSBY COMPANY, 3207 WASHINGTON BLVD., ST. LOUIS 3, U. S. A. 

TABLE OF CONTENTS ON PAGE 6 

Copyright 194S by The C. V. Mosby Company 



'j. 



#> 



CONTENTS FOR DECEMBER, 1948 

Original Communications 

The Role of Surgery in the Treatment of Carcinoma of the Cervix. 

Charles D. Read. M.D., London, England ^"^^ 

Newer Concepts of Menstruation. Irwin H. Kaiser, M.D., Baltimore, ^^^^ 

Leiomyosarcoma'of the Uterus. G. Hamilton Davis M.D., John S. 

Howe, M.D., and Willard G. French, M.D., Brooklyn, N. Y. 1048 

Endometriosis as a Cause of Ileal Obstruction, Paul E. McGuff, M.D 
John M. Waugh. M.D., Malcolm B. Dockerty, M.D., and Lawrence 
M. Randall, M.D., Rochester, Mmn. J"^^ 

Acute Hydramnios. Paul F. Mueller, M.D., New York, N. Y. ---:-- 1069 

Cervical Obturation With Inflatable Cannula in Uterotubal Insufflation 
and Hysterosalpingography. I. C. Rubm, M.D., F.A.C.S., and 
Ernest Myller, M.D., New York, N. Y. 1077 

The Diagnosis of Genital Malignancy by Vaginal Smears. John R. 
Kernodle, M.D., W. Kenneth Cuyler, Ph.D.. and Walter L. 
Thomas, M.D., Durham, N. C. 1083 

A Critical Survey of the Questionable Pelvis. H. Hoffman Groskloss, 
M.D., F.A.C.S., Owen F. Robbins, M.D., and John T. Moehn, 
M.D.,' Minneapolis, Minn. 10^0 

Techniques for Isolation, Maintenance, and Mass Culture of Döderlein's 

Bacillus. Eleanor L. Gilmore, M.S., Raritan, N. J. 1104 

A Comparative Study of the Efficacy of Certain Drugs in Promoting 
Evacuation of the Female Bladder Following Gynecologic Opera- 
tions. Charles Lintgen, M.D., Philadelphia, Pa. 1112 

Simultaneous Intrauterine and Extrauterine Pregnancy. Robert W. 

DeVoe, M.D., and Joseph Hyde Pratt, M.D., Rochester, Mmn. 1119 

Habitual Abortion. Roscoe L. Wall, Jr., M.D., and Arthur T. Hertig, 

M.D., Boston, Mass. 1127 

Necropsy Findings in Patients With Carcinoma of the Cervix. Alex- 
ander Brunschwig, M.D., and Virginia Pierce, M.D., New York, 
N. Y 1134 

Cystoscopy and Pyelography Following Paravesical Extraperitoneal 

Cesarean Section. Edith K. Mangone, M.D., Jersey City, N. J. 1138 

The Bacteriology of Fallopian Tubes Removed at Operation. Marie 

L. Koch, M.S., Baltimore, Md. 1142 

Pyeloureteral Dilatation of Pregnancy After Death of the Fetus. G. 
van Wagenen, Ph.D., and Ralph H. Jenkins, M.D., New Haven, 
Conn. 1146 

A Statistical Report of 1,771 Cases of Hysterectomy. W. C. Weir, 

M.D., Cleveland, Ohio 1151 

The Rate of Renewal in Woman of the Water and Sodium of the 
Amniotic Fluid as Determined by Tracer Techniques. G. J. Vos- 
burgh, M.D., L. B. Flexner, M.D., D. B. Cowie, Ph.D., L. M. 
Hellman, M.D., N. K. Proctor, and W. S. Wilde, Ph.D., Balti- 
more, Md. 1156 

An Investigation Into the Incidence of Abortion in Baltimore. 

Christopher Tietze, M.D., Baltimore, Md. 1160 

Rh Sensitization in a Primipara Caused by Intramuscular Injection 
of Human Serum Resulting in Fatal Erythroblastosis. J. Thorn- 
ton Wallace, M.D., F.A.C.S.. Alexander Wiener, M.D., F.A.C.P., 
and Margaret H. Doyle, M.D., Brooklyn, N. Y. 1163 

Sulfadiazine Concentration in the Blood and Lochia. Bruce P. Zummo, 

M.D., and Louis Rudolph, M.D., Chicago, 111. 1168 

A Full-Term Live Tubal Pregnancy. Julian W. Ross, M.D., and 

Leroy R. Weekes, M.D., Washington, D. C. 1170 

Pregnancy Complicated by Subarachnoid Hemorrhage. M. Garber, 

M.D., F.A.C.S., and R. R. Maier, M.D., Cleveland, Ohio 1174 

Kidney Function in the Fetus. Samuel T. Thierstein, M.D., Fred D. 

Coleman, M.D., and Frank H. Tanner, M.D., Lincoln, Neb. 1178 

{Continued on page 8) 



Page 6 



Am. J. Obst. & Gynec. 



CERVICAL OBTURATION WITH INFLATABLE CANNULA IN 
UTEROTUBAL INSUFFLATION AND HYSTEROSALPINGOGRAPHY 

I. C. Rubin, M.D., F.A.C.S., and Ernest Myller, M.l)., New York, N. V. 

CERVICAL obturation is of major importance in the technical procedure " 
of uterotubal insufflation and hysterography. Regurgitation of CO2 gas 
or oil leads to unreliable estimation of the pressure employed, and not infre- 
quently to wrong interpretation as to tubal patency. Obturation is usually 
secured by pressing a rubber or metal acorn against the cervical os. This is 
easily accomplished in the presence of a round and well-shaped external orifice. 
However, if the external os is irregulär in contour as in lacerations and eversions, 
excessive pressure must be exerted by the acorn in order to prevent leakage. 
of the contrast medium or of CO2 gas as the case may be. To prevent 
regurgitation the cervix must be grasped firmly with a tenaculum forceps 
exerting counter pressure. In this maneuver, the uterus is either pushed up- 
ward or drawn down. To keep the balance by equal push and pull is some- 
times difficult. The anatomic change in position may occasionally be sufficient 
to simulate closure of the tubes by causing artificial kinks at the uterotubal 
junction or by artifically stretching adhesions whieh do not otherwise obstruct 
the tubal lumen when the normal position of the uterus is undisturbed. The 
cannula devised by Colvin with screw tips of various sizes, later modified by 
Hudgins, affords tight obturation but involves a certain amount of trauma 
which theoretically may predispose to embolization. 

• After many years experience with hysterosalpingography and uterotubal 
insufflation the prerequisites of an ideal uterine cannula appear to be the fol- 
lowing : 

1. Its application should be painless and unaccompanied by trauma. 

2. It must provide airtight obturation of the cervical canal. 

3. It should maintain the normal anatomieal position of the uterus. 

The cannula presented in this paper has been devised with these desiderata 
in view It is based on a rather old device, namely, the use of an mflatable 
rubber bulb in order to change the diameter of a rigid Instrument. Nitze, 
the inventor of the cystoscope, made use of this principle for a ureteral 
eatheter. In 1883, a United States patent was granted to Henry E.Finney 
for an Instrument based on the same principle for ' ' the treatment of the ma e 
Urethra." About twelve years ago, one of us (.J-^-R-) construct^ed a cannula 
similar in principle to the one about to be described. Dr. R B. Stout had the 
same idea, except that he placed the rubber balloon withm the uterine cavity. 
Decker,^ in a recent publication, also recommends insertmg the rubber balloon 
surrounding the cannula tip into the uterine cavity. This principle has been 
employed by one of us in studying the differential between uterine and tubal 
contractions during uterotubal insufflation.^ 

1077 



1078 



KUBIN AND MVLLKK 



Am. J. Obst. &Gyne( 
December, 194K 

The present oannula (Fi}?. 1) has develoiwd out of a simple model whieh 

we liave used smce 1946 in 17,5 eases tor cervieal obtunition. Tiie eannula ha. 

the lensth and dianicter- c.f a.i „.•diiui.y „terine s«un.i. Jt .onsists of two 

meta (- liannels, one .,f whieh is very nai-r„w and eiid.s al).)ut 2 em hehind fTe 

ip üt the instruinent. Its openinfj is eovered by a thin, elastie rubber tube 2 

s«ri,^Tsilk"'' " "* '"*' "' """'^ ""' '" '''' ''''"'' "*■ '^' i-fu'-ent by 




tubing distemied. ,b). Extension tip fo? in5."?ron intoTterim' ca^it"? ^""^'''^- <«)• R"bber 

a ute'i'jne" oaür^irilit l'f^'l '"'% '"*" "">' "'''''''' ™»'^' -hieb admits 

a tenaeulum i^ree>,s Th ^' ", ""' ""''•T'''' *« S™**!' »^e eervix with 
tir! V, T P'^^eps 1 In lattei- can l)e reinoved a.s soou as the rul)})er-eovPie<l 

ot the iiiternal os, it may be desii-able to iiisert the eani.iiln witt,' ft V; • !t 
liten.ie cavity. F«,- sueh p„,|,„se the sh,„t t , rT/ ■ " ^ ■ i " '!' ^ 
bv a h)n<>-er öiie (T 1 ( Fi,, n p. r ■ V-, ' '• * '^- '' '"'''y ''e repUieed 

«„/i 1 " /,'. ' *f- ^'- ' """""aiy dilatation, when desirable xlmnM 
not be done jU8t betöre the injeetion of eontrast media «r efore h suffl 
•So far it has beeii po.ssil)le in oui- eases tn intr,„ln„„ ti.„ „ ? usufflat on 
Stenosis after the latter was passed iV a merine so.S """"''' '" '''''"''^ 

The cannida is inserted with the revolvino- AW« n ;., ti. 
presents the engraved letter li (b,dl, on the dise (l-t / Position hat 
indieator. Throufjh hui, A, whieh fits e uer ^^rii.le 1 uU^T^'f ^^^'*^ 
air are injeeted and thus fl e rubber tube .the en 1 nt^'th * '• °* T"*'"' •"" 
disteiided (Fi..- 1«) Wi l, ., i/tu • * *"*" "«ti'U'nent beeoiiies 

II, 1 r.ffi • ^;i "^^ V , "''*♦'«" exi)enenee one can soon feel whether the 

Intüjted^ba"?;::; 'L^;^Ä ;■ :x!ii::T;'za::l;:' ''-■ ^--^ ^ 

a manometer to hub A. On' turninl t he disL" ba'e^ "A 'e' ^Si^ withtn the 
rubber halhu.n will be pron.ptly indieated on the manometer. THs toÜe notl^l 

B. 56 Ireef"" "viVo^rN." y.'"''"'" "^ '"'"" "'"' '"-'tributed by United Surgical Supply Co.. MO 



Volume 56 
Niimber 6 



INFLATABLE CANNULA FOR CEHVICAL OBTURATION 



1079 



that it* less than 1 c.c. of air or water is used to inflatr the halloon, the i)ressiire 
readin^-s in the halloon may not he acenrate. Xow the dise is turned to the Posi- 
tion marked hy the letter (' (elosed) and the instnmieiit is ready for the pro- 
cedure. 




Fig. 2.— Inflatable eannula fllled with diodrast obturating the cervical canal. Note that itis 
pyriform or acorn in shape as compared to the oval-shaped inflated eannula outside of the Dody. 

The dise is now turned to the position X (= x-ray) thus eonneeting huh A 
directly with the tip of the instrument inside the eervieal eanal, or to tip T2 
in the' uterine eavity. A Luer syrin«e eontaininj? the eontrast medium is 
connected to hui) A and the medium is injeeted into the uterus and the x-ray 
exposure follows. For fractional injeetion of eontrast medium, the (hse is 
turned to position C after the first fraetion is introdueed. Hands and synnge 
may now be removed because the expanded bulb retains the eannula in situ.* 
By'turninj? the dise hack to i)osition X the second fractional injeetion can be 
made, and if need be, a third or fourth. 

When the kymooraph is employed it is connected to hub A and the disc is 
turned to position X. The insufflätion test can be carried out with a 20 c.c. 

^ special clanip adaptable to any vaginal speeuluni has been devised to keep the ean- 
nula in the horizontal position. 



1080 



RUBIN AND MYLLEK 



Am. J. Obst. & Gynec. 
December, 1948 



Luer syringe attached to hub A. The disc is turned to position R (= Rubin 
test) which enables us to mea.sure the exertcd pressure by connectmg the man- 
ometer to hub B. In the simplified test, 20 c.c. of carbon dioxide injected by 
a syringe is sufficient because of the complete closure of the cervix without any 
leakage. A sudden fall of manometric pressure is indicative of tubal patency. 
If Shoulder pains result they are minimal.* 

By inflating the rubber bulb with an aciueous eontrast medium (e.g. 
diodrast) one oan easily demonstrate the relation of the bulb to the cervical 
canal (Fig. 2). In order to note the distensibility of the intracervical balloon 
and any changes that the cervical walls might exert upon it, another cannula 
with the balloon filled with an equal amount of diodrast was exposed at the 
same time on the same x-ray film. The shape of the balloon inside the cervix 
may be compared to the external balloon in Fig. 2. In Fig. 3, water has re- 
placed the diodrast and is therefore invisible, while the uterine cavity is 
Seen filled with eontrast medium. Incidentally, the cervical balloon reveals a 
configuration which does not conform to what one notes in conventional draw- 
ings of the cervical canal because of distention by the rubber balloon. The 
cervical canal appears, from our study, to yield readily to a greater degree of 
dilatation than has hitherto been realized.f 

Owing to rigid walls, some cervices were found to resist balloon distention 
with 2 to 3 c.c. of water. Nevertheless, good obturation could be obtained with 
less Alling. If the rubber part of the instnunent is not inserted deep enough 
into the cervical canal the balloon mav bulge through the external os. How- 
ever, this does not prevent airtight closure. Should the rubber bulb be pushed 
out entirely from the cervix it mav be reinserted and kept in place by grasping 
the anterior lip of the cervix with a tenaculum forceps. In several cases the 
cervix was found transformed into a shallow cone. Airtight closure could 
be obtained in these cases by advancing the expanded rubber bulb into the 
cone while the cervix was held in place by a tenaculum forceps. 

The present cannula has the advantage over the ordinary cannula with an 
acorn tip in that it brings a larger area of the endocervix in contact with 
the acorn. Hence, the pressure required to obturate the cervix is less. As 
this pressure is not only directed upward, but upon all sides, dislocation of the 
cervix does not as a rule result. 

The pressure within the rubber balloon automatically predetermines the 
maximum pressure which is intended to be used for the insufflation test or 
salpingography. If, for example in the bulb is 250 mm. Hg and the pressure 
used during insufflation or salpingography is higher, no matter how little this 
may be, there is prompt escape of the gas, or oil from the cervix. The same 
physical law operates here as in measuring blood pressure. If the blood pressure 
exceeds the pressure in the armcufP, the pulse wave immediately returns. 
The balloon in the present cannula thus forms a desirable safety valve which 
automatically prevents an undue increase of pressure inside the uterus. 

This feature of the Instrument is of importance for salpingography. 
Usually a eontrast medium is used which has a certain viscosity. Pressure 
determinations when lipiodol or other viscous fluid is used are not accurate 
because of the considerable friction inside the small lumen of the cannula 
where a rapid decrease of pressure takes place with each progressive centimeter 
of the lumen. When the constrast medium enters the uterine cavity the 

•The senior author does not recommend or employ the use of the syringe for injecting 
CO2 into the uterus for testingr tubal patency, preferring insufflation by means of the automatic 
Siphon meter with Icymograph. The present cannula is adniirably adapted for this apparatus. 

tThis poInt of elasticity of the cervix under various condltions will be the basis of a 
future publication. 



Volume 56 
Number 6 



INFLATABLE CANNULA FOR CERVICAL OBTURATION 



1081 



pressure inevitably falls. If tubal obstruction is encountered there is a gradual 
increase of pressure inside the uterus until it equals that which is exerted by 
the syringe. Before this point is reached a high pressure may be exerted 
through the syringe which is not usually appreciated by the Operator unless 
he uses a manometer. The rubber balloon afPords safety because when the 
pressure exceeds that within the bulb, the oil escapes at once through the 
external cervical os. 




Fis 3 — Inflatable cannula filled with water (therefore invisible by x-ray) obturating 
tho cerifcal canal The eontrast medium (rayopaque) demonstrates the Sterine cavity. The 
rubber baUoorSistendedby diodrast is seen below outside of the body for purpose of comparison. 

The Instrument can be sterilized by boiling The rubber biilb jan stand 
boiling many times; its cost, however, is so small that it may readily be replaced 
for efch test. We'have found it practical to ^^^he bulb before mser mg the 
cannula in order to note whether it is watertight however should the 
rubber break it is immediately appreciated by the drop ^^^ .f^f^ance^ ,J^^ 
water escapes through the external os and does no härm. It is particularly to 
b^ noted that the Operation of the cannula is exceedingly simple, and after some 
little experience, requires a minimum of time. 



1082 



RUBIN AND MYLLER 



Am. J. Obst. & Gynec. 
December, 1948 



Conclusions 

The importaiiee of eervieal ()l)tiiratiüM in tlie proeedure of uterotubal 
insuftlation and hysterosalpinjjfo^raphy has heen emphasized. Desiderata of the 
ideal uterine eaiinula are : 

1. Painless applieation unaeeompanied hy traiima. 

2. Airti«>ht elosure of the cervieal eaiial. 

3. Maintenanee of the normal anatomieal i)().siti()n of the utenis. 

A new eaniiula with inflatable balloon for eervieal ol)tin*ation has been 
described. 

References 

1. Personal coniinunication. Acknovvledgnient is herewith niade to K. H. 8toiit MI) for 

his kindness in lettin^ us see hi.s instrunient. » - • v 

2. Decker, Alhert: Am. .T. Ohst. & Ctynec. 54: 1077, 1947. 

3. Rubin, I. (\: Am. .1. Okst. & (iwv.c. 45: 411), 1948. 



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NEW .^ YORK 



Keralb<ga6^arr(bune 

New York QCT 2 4 1953 



Dr. Ernest Myller, 
Gynecolo^Sl, 60 

Dr. Ernest Myller. sixty, a 
gynecologist and obstetrician 
with Offices at 65 E. 76th St.. 
died yesterday of a heart attack 
at his home, 450 E. 63d St. He 
was on the staff of the Post- 
Graduate and Madison Hospitals. 

In 1933 Dr. Myller. chief gyne- 
cologist, and surgeon at the 
Marthaheim Hospital in Nürn- 
berg, Germany, was driven out 
of the country by the Nazis. He 
went to Athens where, within a 
year, he had passed the Greek 
medical examinations, though 
he had not known the language 
before his flight from Germany. 

For seven years he was head 
of a private hospital in Athens. 
In 1941, when the Nazis invaded 
Greece, Dr. Myller was rescued 
with his family by the British 
Navy. He had been in the United 
States for twelve years. 

Dr. Myller had designed In-') 
struments used in the detection, 
of Cancer in the Uterus and ap- 
paratus used for the eure of 
sterility. 

Surviving are his wife. Mrs. 
Liselotte Myller, and a son, 
Ralph Myller. Another son. Lt. 
Ulrich Myller, was killed in 
action in Korea. 



J\R [OWC Collect Jon wlffi 





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Ernst Müller, M.D. 

Ernst Müller was bom of February 26, 1893 in Schmalkalden, Thüringen, Germany. 
Schmalkalden, was a small town of approximately 10,00() inhabitants, including a few Jewish 
families. 

Emst's parents were Joseph and Clara who owned and operated a Pharmacy called Germania 
Drogerie, which was located on the main Square of town in a house flanked by the hotel and 
the church. The living quarters were above the störe. 

After completing high school (Gymnasium), Ernst left to study medicine, and attended the 
Universities in München, Kiel, Berlin and Würzburg where he joined a Jewish fratemity called 
Veda. Throughout his life he stayed in contact with bis fratemity "brothers". While in Berlin 
he decided to specialize in gynecology, obstetrics and surgery and intemed at the clinic of Dr. 
Strassman. 

In World War I, he served as an army doctor at several military hospitals as well as at the 
front, where he was wounded several times and was decorated with the iron cross. After the 
war, he settled in Nürnberg where his practice gradually flourished, as did his excellent reputa- 
tion . He was 32 years old when he met the 19 year old Liselotte at a party. She was the 
daughter of Marta and Stefan Hirschmann, the director of the Bayerische Hypotheken & 
Wechsel Bank in Nürnberg. 

Liselotte and Ernst were married in 1926 and had two sons, Rolf bom in 1926 and Ulrich four 
and a half years later. The were a happy family who lived in a beautiful town house, content 
and prosperous, sharing their many interests and hobbies. 

Then came the catastrophe: — Hitler! 

In 1934 the Müller family escaped to Greece, where Emst had to take and passed the medical 
licensing examination in Greek, before establishing a successful practice. The family acquired 
Greek citizenship and in the process the name Müller was changed to Myller. In 1941 they 
were forced to flee the Nazi invaders, this time ending up in America. In New York, after a 
long and hard struggle, Emst built up his third successful career before he died at the age of 
60. Ulrich, his younger son was killed in 1953 in the Korean war. 

Rolf became an architect, married Lois Westerdahl, a lovely New York girl, and they have 
iwwonderful daughters, Elise and Corinne. Liselotte married Ely Jacques Kahan, the New 
York architect, 10 years after Emst's death. 

For more Information on Emst Müller's life, please read Liselotte's Memoirs, which she wrote 
in 1970 under the name of Kahn, her second husband. A copy of her memoirs can be found in 
the archives of the Leo Baeck Institute in New York City. 



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: NEW YORK TIMES, SATURDAY. OCTOBER 24, 



DR. ERNEST MYLLER, 
GYNECOLOGIST, 60 

Staff Aide of 2 Hospitals Here 

Who Headed Institutions in 

Germany and Greece Dies 



Dr. Emest Myller, gynecologist 
and obstetrician on the staffs of 
the Madison Avenue and Univer- 
sity Hospitals, died of a heart at- 
tack early yesterday at his home, 
450 East Sixty-third Street. His 
age was 60. 

Dr. Myller had headed hospitals 
in his native Germany and in 
Greece before Coming to this coun- 
try as a refugee from the Nazi» 
wtlve year» ago. He wa» ttm 
JUMil^ of a jiiwnber of scientific 
p2^ners in the field of gyneco^gy, 
•nd V^» 4esig?ier q^^ msiinisamt^ 
uatd m th* ii«iu ot sberiU^y a^ 
fior tli« d^^eetion ©< eancer of tne 
Uterus, 

At his death he was secretary 
of the Rudolf Virchow Medical 
Society and chairman of the Con- 
ference of the obstetrical board at 
Madison Avenue Hospital. He also 
was an assistant attending gyne- 
cologist at University Hospital, a 
member of the county, State and 
national medical societies, and a 
diplomat of the American Board 
of Obstetrics and Gynecology. 

Born in the health resort village 
of Schmalkalden at the foot of the 
Thuringian Forest in former Prus- 
sian Saxony, Dr. Myller was grad- 
uated from the medical school at 
the University of Berlin in 1918. 
By the early Thirties he had be- 
come Chief gynecologist and 
surgeon and head of a hospital in 
Nuremburg. 

After the rise of Hitler to power 
in 1933, Dr. Myller and his family 
were forced to flee to Greece be- 
cause they were Jewish. There he 
mastered the Greek language, 
passed the medical examinations 
within a year, and opened a small 
private hospital in Athens, which 
he headed f or the next seven years. 
When the war began Dr. Myller 
undertook secret work in Greece 
for British intelligence, and in 1941, 
when the Germans invaded Greece, 
he and his family were evacuated 
from the country on a British naval 
vessel. Within a year he came to 
this country and settled in New 
York, where he resumed his medi- 
C8Ä practice. 

Dr. Myller is survived by his 
widow, Liselotte, and a son Ralph. 
His younger son, Lieut. Ulrich 
Myller, was killed in Korea three 
months ago. 




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CITY OF NEW YORK 

DEPARTMENT OF HEALTH 

BUREAU OF RECORDS AND STATISTICS 



Borough of 



MANHATTAN 



New York. N Y. 



NOV-5 1953 



Below it a photoitatic copy of o certificate on file in the Bureau of Rocordt 
and Statiitici of tho Department of Health of the City of New York. 



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(a) NKU YORK CITY: (b) Boroufh 

(c) Namr .,( Iloapilal ^^J^/J /V/ /" ^^ -^lÄ 

or Intlitulion '..."...^....T...r*1^..'.. ~..Z... .. .^T. 

(II MW ■■ htMpitml «r iNirtViittoN, fit-* ttVtrt *i^ kümbtt.) 

(d) If in hci>|iital, fivc Ward No. ^ 
(Uonth) (Uay) 



U DATE AND 
HOUR OP 
DEATH 



^_ (Year) | (llout) 



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l? SOCIAL SKCURITY NO 



BIRTHFLACK 

(Statt or Forrign Coufitry) 

OP WHAT COUNTRY WAS^ 
DKCKASKH A CITIZKN 
AT TIMK OF OKATII? 

loa WAS OKCKASKO FA. 
IN UNITKO STATKS 
AKMi:n FOHCKS' 



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aiid laM saw h »'«ü alive at U 4M on 0*rfi irlt " \9/i 

1 fiirtlwr urtify ttut death iO^^ H O f cauiwl. directly 
i>r iiiilirciily by accidt-iit. honiicidr, suicidr. acute or ilirotiic 
|H.iv.iimK. «>r in any siispicious or unusual maiincr. aiid that it 
was duc to NATURAL CAUSKS n».)re fully dcscribc«! in the 
tiMifuIrntial mcthcal rcj«)« fiW »ith tlie l)e)>artnicm uf Health. 

* ( >>■(! Q<tt us>tit tktt d» mat »ffly. 

t .Sri- ^tst iMStiHiliom vm »rtvr». vf ctrlifcatt. 

Witiifss niy haiul thi» '^J <Uy of L^^ JT ^ "ff V. "%» 19 wT^ 



In 



li; OF INFI 



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IIP V^ DKCFASED AnDREfiS_^ /^ ^^"^ x*Ar 1/ J 

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jr-^ ' -• y^ ^ l4<Ci,ocatiui#(Citv~To«n or CWin(\ »Bil Sl»I«) Mc^jJatr 



fu kl AI Ol RKORDS .AND SrATLSlICS ^ DEPARTMENT OF HEALTII O TY OF NE^ YORK 



c^rtlfy tSa» ♦ ••■ ^orcOv 



CARL L. tRHAKi)T 



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TO BE GIVEN TO 
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No. 6 669 586 



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-The'United States -" 



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Brooklyn-- — 



ERNEST MXLLER 




M^i^JitZ/ri^^ d gg-35 Elmhurs t Avenue, Elmhurst, New ^Qj;^ .> 

y/yyj/y J^ February /^^^^m^^^^^K^^^^^W/^^ 

forty seven jm///j^yM^\ Ai//f^n/Jl^/»/^^/^^ 

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.Uin.i.li.ii..i.M;tni..] ..i-i.»iHHrta 



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Di« chirurgische Therapie des Vorfalles der Genital organe 

durch sutfuiidüle Uterusamputation. 



Von 
Prof • Dr. Konstantin Logotlietopiilos, Direktor der I Frauen- 
klinik in Athen. 



Die chirur^-ische Therapie des Vorfalls der Geni- 
tal organe besteht, wie "bekannt: 
1.) in der Wiederherstellung des muskulösen Eeckenhodens 

mit der herausnähme des infolge des Vorfalls überflüssi- 
gen Teiles der vorderen imd hinteren vaginalen Wand und 
2.) in der Wiederaufrichtung des Uterus in Anteflexions- 
Stellung* 



Das Verfahren ist leicht bei Vorfall 



der 



Scheide 



mit leichter nach hinten und unten Verlagerving des Uterus. 
Bei diesen Fällen genügt die vordere und hintere Vaginal- 
plastik mit der Aufrichtung des Uterus durch Verkürzung 
der ligg. rotiinda nach irgend einer der zahlreichen Metho- 
den zur Erreichung eines guten und dauernden Resultates. 
Bei dem parziellen oder totalen Vorfall des Uterus aber, 
mit oder ohne Verlängerung der Portio verlangt die Therapie 
einen erweiterten chiriirgischen Eingriff, der oft das Deben 
der Trau gefährdet. Das Prinzip der Operation ist auch bei 
diesen Fällen im allgemeinen das gleiche, d.h. Bildung eines 
starken muskulösen Beckenbodens und i^ef estigung des Uterus 
in Anteflexions Stellung. Da aber die Verkürzung der ligg. 
rotunda in diesen Fällen sich als ungenügend erwiesen hat, 
wird der Uterus direkt auf die Bauchwand genäht, am besten 
nach der ihethode von Kocher. Durch diese Methode wird der 
Uterus eher nach oben gezogen als in Anteflexions st eilung 
gebracht. Trotz dieser Befestigxing kommt es oft vor, dass er 
durch Dehnxing der Verwachsungen wieder nach unten verlagert 
wird. Die zwischen Uterus und Bauchwand entstandenen Taschen- 
bild\mgen haben oft eine Darmverschlingung zur Folge. Eine 
gute iiixethode, die ich auch früher oft angewandt habe, ist 
die VaginifiJtation nach Schauta-^ertheim. Durch diese 
Operation in Kombination mit der vorderen und hinteren 
vaginalen Plastik und die Bildung eines starken Perineums 
durch die Levatorennaht wird nicht nur eine feste muskulöse 
Basis gebildet, sondern auch der Uterus in Aneflexionsstell\ing 
befestigt, gleichzeitig wird die Blase nach oben verlagert 
und ruht nunmehr aizf der hinteren Uteruswand. Zur Vermei- 
dung von Rezidiven empfiehlt Wertheim die Verkürzung der 
ligg» sacrouterina durch Naht. Diese Operation gestaltet 
die Prognose noch schwerer. Wertheim selbst hat von 252 auf 
diese Weise operierten Fällen 16 verloren. Statt dieser 
Originalmethode ist die Modifikation nach Kielland vorzuzieh- 
en. Durch diese Operation wird der zwischen Corpus und Cervix 



mmmm 



tss. 



r 



n 



-2- 



z' 



uteri vorhandene V/inkel aiifgehoten und die Gervix wird 
dadurch auf die hintere Vaginalaxe verlagert. Die Vagini- 
fixation nach Schauta-Wertheim mit oder ohne die Modifizier- 
rung nach Elielland habe ich in der letzten Zeit wegen der 
relativ grossen Mortalität und wegen der nicht seltenen Re- 
zidiven verlassen. Ebenso wende ich aus dem gleichen Grunde 
nicht mehr die vaginale Total extirpation an, die ebenso gute 
statische Resultate iibt, aber doch einen grösseren Eingriff \ 
darstellt, sondern begnüge mich mit der Abtragung des gan- ^ 
zen unteren Teiles des Uterus im Zusammenhang mit der Bildung q 
einer engeren Vagina und eines starken -t^erineums. Die Ope- 
ration ist leicht auszuführen und hat mir bis jetzt die 
besten Resultate gegeben» Sie ist im Prinzip der hohen 
Portioamputation ähnlich, mit dem Unterschied, dass der Ute- 
rus viel weiter oben bis zum Fundus abgetragen wird, wofür 
ich den i^ahmen subfundale Uterusamputation vorschlage. 

Die Operation wird auf folgende Weise ausgeführt: 
die Portio wird mit Kugelzangen gefasst und stark nach ab- 
wärts gezogen. Nun wird die Scheidewand in ihrer ganzen Dicke 
mit einer kräftigen gebogenen Schere ¥2 cm. oberhalb des 
Überganges der Scheide in die Portioschleimhaut zirkulär 
umschnitten und teils stumpf, teils mit der Schere etwas 
nach oben prepariert. Die Blasenwand wird jetzt nach oben 
zu abgespannt und mit kleinen Schnitten die nun deutlich 
sichtbar werdenden vesicocervikalcn Bindeglied stränge ge- 
trennt und dadiirch die Blase von ihren festeren Verbindungen 
mit der ^ervix losgelöst. Die Blase wird nun mit dem Pinger 
nach oben geschoben. Nachdem auch die seitlichen Blasen- 
partien nach oben und nach der ^eite geschoben werden sind, 
legen wir das vordere Vaginal Spekulum unter die Blase und 
bringen sie und die Ureteren auf diese Heise ausserhalb 
des Operationsgebietes. Das nun deutlich sichtbare Perito- 
neum wird mit einer Pinzette gefasst und mit einem Scheren- 
schlag geöffnet \ind die Öffnung nach beiden Seiten erwei- 
tert. Das so geöffnete Peritoneum zieht sich von selbst 
oder mit Nachhilfe des Pingers durch das Abwärtsziehen des 
Uterus zurück und wird mit einigen Nähten auf die vordere 
Uteruswand 2 t/2 - 3 cm. unterhalb der Fundus ob er fläche be- 
festigt. Die Scheide wird dann auf beiden Seiten hochgescho— 
ben, nachdem die Utering efässe mit Klemmen gefasst und unter- 
bunden worden sinf . Die Portio wird stark nach vorne ge- 
zogen, das Douglasperitoneum geöffnet, nach oben geschoben 
und auf die untere Uteruswand und in der gleichen Höhe 
mit dem Blasenperitoneum mit einigen Nähten befestigt. 
Der nun freiliegende Uterus wird direkt unterhalb der 
Peritonealnähte mit dem ^esser oder mit der Schere abge- 
tragen. Die Uteruswunde «vird nach der Methode von Sturm- 
dorf mit der Vaginalwandung bedeckt. Bei kleinen atrophischen 



._ "Tr i i r i fc'' -^T- ^"""-"-^"- " •— ^' 



r 



n 



-3-- 



ynd>ntiiAA- 



uteri verzichte ich auf die Öffnung des Peritoneiims, das- 
selbe wird möglichst hoch geholieliezi und der Uterus direkt 
unterhalb der Ins ertionsst eile des Peritoneums abgetragen. 
Anschliessend wird die vordere und hintere Vaginal plastik 
und die Bildung eines festen Beckenbodens vorgenommen. 

Auf diese Weise habe ich selbst im ganzen 71 
Fälle operiert, ZOio davon waren äusserst herxint er gekommen 
als Folge der schlechten Ernährungsverhältnisse, die seit 
^ Jahren in G-riechenland herrschen. Ein Beweis, dass die 
mangelhafte Konstitution in der Äetiologie des Prolapsus 
eine grosse Rolle spielt. 

Eine eingehende Beschreibung aller einschlägigen 
Krankengeschichten an dieser Stelle wäre wohl zu weit- 
gehend, sie wird übrigens von meinem Assistenten Dr. 
Galanopoulos an anderem Ort veröffentlicht werden. Hier 
möchte ich nur noch kixrz über die Resultate berichten. 

Von den 71 Fällen hatten 27 einen partiellen und 
44 einen totalen Uterusprolaps. 

Der Uterus war in Mittelstellxmg bei 44 Fällen, 
in Retroflexio bei 36 iind in anteflektierten Stellung 
bei 11. Bei 64 Fällen wurde allgemeine Aethernarkose an- 
gewandt, bei 7 Evipan-Na. und bei einem Lokalanästhesie. 
Die Dauer der Operation war im Mittel 29 Minuten. Die 
Länge der Uterushöhle schwauikte zwischen 4 und 15 cm# 

Von diesen Fällen sind zwei, gerade die letzten, 
gestorben. Der eine an septischer Urämie und der andere an 
Embolie. 

Nachiint ersucht wurden: 2 Fälle nach 3 Monaten, 4 
Fälle nach einem Jahr (weitere 5 Fälle nur durch briefli- 
che Anfrage). Ein zweites Mal kamen hiervon 20 Fälle nach 
18 Monaten zur Nachuntersuchung. 

Was die subjektiven Beschwerden betrifft, klagte 
von den mindestens 6 Monate danach untersuchten Fällen 
keine mehr über Zug oder Druck nach unten, 6 klagten über 
Kreuzschmerzen, 3 über Schmerzen beim Goitus, 5 hatten 
psychische Erscheinungen, alle Patientinnen waren voll 
arbeitsfähig. 

Die Menstruation war normal bei 23, 8 hatten 
Amenorhoe wegen Unterernährung, 9 Oligomenorhoe mid 24 
AI t ersamenorho e . 

Die objektive Untersuchung ergab bei 5 leichte 



\ 






r 



n 



-4- 



Inversion der vorderen Vaginalwand ohne subjektive Be- 
schwerden» Alle anderen ohne "besonderen Befund. 

Die zweite Untersuchung "bei 20 Kranken 10 Mo- 
nate nach der Operation ergab folgendes: keine Patientin 
klagte über irgendwelche Beschwerden. 2 klagten über Kreuz- 
schmerzen, 1 über Beschwerden in der Miktion. Alle waren 
arbeitsfähig. Bei keiner trat Gravidität ein. 

Die objektive Untersuchung ergab bei einer eine 
leichte Inversion der vorderen Vaginalwand, sonst bei allen 
keinen besonderen Befund. 

l±e aus dem Vorhergehenden sich ergibt, sind die 
Resultate dieser Operation so günstige (ich habe bis jetzt 
keine Rezidive beobachtet »nd ausser den beiden angeführten, 
nicht auf die Art der Operation zurückzuführenden Fällen, 
kein weiterer Todesfall); dass dieser Eingriff momentan in 
meiner Klinik bei grossen Utcrusprolapsen die Operation 
der Waiil darstellt. ] 

Der Vorteil der Operation ist, dass die Ausführung 
leicht ist, die Cxefahr äusserst gering, da man mit der ^ 
Peritonealhöhle gar nicht in Berührung kommt, und bei 
jxingen Frauen bleibt die i'eriode erhalten. 



'-^^ 



r 



n 



Therapie der atonischen Blutxing nach der ^eburt der 

i;lS25Gi&ji 



von 



Prof. Dr» Konstantin Logothetopulos, Vorstand der I. 
Universitätsfrauenklinik in Athen» 



Eine der "bis jetzt noch nicht ganz gelösten Fra- 
gen in der Geburtshilfe ist die Bekämpfung der atonischen 
Blutung nach der Geburt der Plazenta* Trotz allen bis jetzt 
bekannten Mitteln geht Immer noch eine Anzahl von jungen, 
blühenden Frauen zu Grtinde. Nur derjenige der solche Eälle 
niite^^lebt hat, ist im Stande, die Tragik eines solchen Todes 
zu beurteilen. Mit Recht sagt Labhardt '•er habe das "^efühl, 
man könnte sich in einen Todesfall durch Eklampsie oder 
Plazenta praevia viel eher fügen als in einen durch Atonic 
veranlasst en#" 

Alle die bis jetzt angegebenen Blutstillungsmittel 
Bind \insicher und die direkt durch Druck oder Zug auf die 
Blutgefässe wirkenden Methoden schliessen grosse Gefahren in 
sich» Es wäre zu weitgehend, wenn ich alle diese Methoden 
und die Wirkung demselben kritisiere, es steht ausführlich 
in allen Lehrbüchern der Geburtshilfe» 

Man rechnet jetzt auf eine Sterblichkeit an ato- 
nischer Blutung nach der Geburt von 0,05/^* Grosse Blutver- 
luste aber schädigen den Gesamtorganismus und schränken sei- 
ne Abwehrkräfte gegen Infektion ein» Wenn man also auch die 
Fälle mit dazurechnet, die infolge des Blutverlustes an 
Infektion sterben, wird die Mottalitätsziff er sicher grösser 
sein» 

Seit ich meine Blutstillungsmethode ft^ Notfälle 
bei gynäkologischen Operationen angewandt habe/ dachte ich 
diese Methode auch in der Geburtshilfe bei atopischen 
Blutungen anzuwenden» Trotzdem aber so viele Jahre vergangen 
sind, ist mir keine Gelegenheit geboten worden, bis ich vor 
zwei Jahren in meiner Klinik eine Patientin vorfand, die 
fortwährend blutete, trotzdem bei ihr Blutstillungsmittal 
und eine starke Uterus tamponade angewandt worden waren» 
Ich habe sofort aus dem Uterus die Gaze entfernt und meinen 
Tampon eingeführt» Die Blutung sisticrte sofort» Seit 
diesem Fall wurde in meiner Klinik die Methode noch sechs- 
mal angewandt mit promptem Erfolg. 

Sie wird auf folgende Weise ausgeführt: Die Pa- 



r 



n 



~2- 



^am 



ctUl 



^(tC^3 



^aUA 



ti entin wird auf ^ucrbett gelagert, die äusseren Genitalien 
werden gesäubert, die Scheide desinfiziert und die Blase 
durch den Katheter entleert • Nach Einlegung de» vorderen 
und hinteren Vaginal Spekulums werden die Muttermundlippen 
mit Kugelzangen hoch gefasst und die Portio fest nach unten 
gezogen. Dann werden die Vaginal Spekula in den Uterus ein- 
geführt, so dass der Muttermund weit offen gehalten wird# 
Darauf nimmt man ein quadratisches Gazestück, dessen Mitte 
mit einer Icngen anatomischen Pinzette oder mit einem 
Stopfer in den Uterus eingeführt wird» Nachdem die heraus- 
hängenÄto Zipfel der Gaze von dem Assistenten auseinander- 
gehalten werden, wird ein langer Gazestreifen in den 
Uterus eingeführte und gleichmässig nach allen Richtungen 
verteilt, so dass ein Kindskopf j^rosses kugelförmiges Gebilde 
darin entsteht« Die vier Zipfel der äusseren qLuadratischen 
Gaze, sowie das heraushängende Ende des Streifens, welches 
zu unterscheiden etwas länger sein muss als die vier Zipfel, 
werden mit der rechten Hand gefasst und fest nach unten 
gezogen, bis der kugelige Tampon in das kleine Becken ein- 
tritt und auf die Uteringefässe einen Druck ausüben kann.f- 
Man zieht dann die 5 heraushängenden Zipfel durch ein grosses 
Ringpessar, das man mit der linken /iand fest z^Z^"^ d©^ 
unteren Teil der Symphyse, die absteigende Schambeiiiäste 
und den Beckenboden anpresst, viährend die rechte Hand mit 
aller Kraft an den Zipfeln zieht^ Zur Vermeidung von Nekrosen, 
die durch zu starken Druck auf die Vulva entstehen könnten, 
lege ich zwischen Pessar und Vulva auf beide Seiten des 
Tamponstieles einen kleinen Wattebausch. Nun leg* ein 
Assistent eine starke Klemme vor dem Pessar, dass das sich 
nun zwischen Vulva und dieser Klemme befindet-f Die Blutung 
nach Einlegen des Tampons hört mit aller Sicherheit sofort 
auf, wie aus den Fällen über die ich gleich berichten werde 
zu ersehen ist» Bei allen Fällen wurde der TamJJon nach 5 
Stunden entfernt, um die Gefahr der Infektion infolge langen 
Liegens der Gaze im Uterus zu v ermüden» Man ksuin ev» die- 
selbe noch früher herausnehmen, wenn der Uterus sich in- 
zwischen gut kontrahiert hat» Ausser der prompten Wirkung des 
Tampons infolge des ausgeübten Druckes auf die Uteringe- 
fässe, besitzt er auch die Vorteile der gewöhnlichen Tampona- 
de, d»h» er ruft einen starken ^ontraiktionsreiz auf den Uterus 
hervor und beim Entfernen der Gaze werden Eihautf etzen und 
Blutkoagula mit entfernt» Die Nachteile der gewöhnlichen 
Tamponade fallen hier zum grossen Teil weg: 



i 



I 



1» Die Durchführung dauert nicht lange, da nicht die 
ganze Uterushöhle mit Gaze gefüllt wird» Selbstverständlich 
muss der ^ampon sterilisiert in einer Büchse immer bereit 
stehen» 

2» Schädigungsmöglichkeit kommt nicht vor, da der Zipfel 
der ^uadratgaze nicht bis zum Fundus Uteri eingeführt zu 
werden braucht» 

3» Die Infektionsgefahr ist äusserst gering, da nur die 



r 



n 



-3- 



erste Gaze Direkt mit den Uteruswari düngen in Berührung 
koioiat* 



4. 
weg# 



Die Schnierzhaftigkeit bei entfernung der Gaze fällt hier 



zu 



Die nach Einführung des Tampons bemerkbare Zu- 
sammen Ziehung des Uterus ist nicht nur auf den ausgeübten 
Reiz, sondern auch auf die durch die Absperrung bedingte 
Anaemi e des Organs wie es auch bei der Drosselung der Blu- 
zufuhr durch die Aortenkompression der Fall ist* Vielleicht 
auch durch den ausgeübten Druck auf dma Ganglion von 
Fr ankenhäus er • 

Was die Indikationsstellung betrifft, bin ich 
der -Ansicht, dass man mit der Anv/endung des Tampons nicht 
lange v/artet. Man kann ja im voraus nicht wissen, bis zu 
welchem Grade die Patientin eine Elutimg vertragen kann» 
Wenn man sich über die Intaktheit der Plazenta überzeugt 
hat und die Blutung nach kräftiger Massage des Uterus und 
Einspritzung von Blutstillungsmitteln fortdauert, bereitet 
man die Patientin zur Einlegung äes Tampons vor» Inzwischen 
kann man eine heissc vaginale oder Uterus spühlung vorneiimen. 
Bleibt der Erfolg aus, wendet iftan gleich den Tampon an, 
indem man auf alle anderen bekannten Blutstillungsiüethoden 
verzichtet» 

Die »"irkung ist so prompt xind sicher, dass ich 
es nunmehr als einen Kunsti^ehle r betrachte, wenn eine 
Patientin an atonisoher Blutung nach der Geburt stirbt» 



Die in meiner Klinik beobachteten Fälle sind 
folgende: 

Fall 1) Protokoll Nr. 557A941. Frau K.K., 27jährige Ipara* 
Letzte Menses am 10»5*194-0» Aufnaiime in unserer 
Klinik 12 »2 »1941, 6h» Gebxirtshilflicher Befund: 
Fundus uteri 2 1/2 Finger breit unterhalb des Pros, 
xiph. I Schädellase, Schädel im Beckeneingang beweg- 
lich» Herztöne (-}• Beckendurchmesser: 23, 25, 29, 
18» Vaginal: Muttermand handteil ergross von Plazenta^ev 
gewebe überdeckt, ziemlich starke Blutung. Allge- 
meiner Zustand schlecht. Puls 130, Temperatur 36,8. 
Mit Rücksicht auf das Fehlen der kindlichen Herztöne 
und des allgemeinen Zustandes der Graviden entschliess* 
man sich zur Uterusentleerung per vias naturalis» 
7h» Nach vorheriger Durchbohrung der Plazenta wurde 
der vordere Fuss gefasst und gewendet. 7h»15» Sponta- 
Entwicklung des Kindes» Die Plazenta wurde unmittelbar 
nach der Entwicklung der Frucht manual gelöst» Die 
Blutung dauert fort trotz der Verabreichung der 



r 



n 



t4- 



Fall 2) 



Fall 3) 



gewöJfinlichen ELutstillungsinittel. Auch die Uterus- 
Bcheidentamponade nach Bumm brachte Äicht den 
gewünschten Erfolg. Deshalb wurde sie entfernt und 
statt ihrer mein Tampon eingeführt, worauf die BIut 
tÄng prompt aufhörte und der ^terus sich stark kon- 
trahierte* Obwohl der Erfolg der Blutstillung durch 
den Tampon in diesem Fall auffallend war, ist die Pati- 
entin 1/2 Stunde später wegen vorangegangenem grossen 
Blutverlustes ad exitum gekommen. 

Erotok. Nr. 608/1941. Frau K.D., 30jährige Ipara. 
Letzte Menses am 27#4.1940. 22h. 15.2*194l, Wehen- 
beginn. 9h. 10, 16.2.1941, Aufnahme in unserer Klinik. 
Geburtshilflicher Befund bei der Aufnahme: Fundus 
uteri 3 Finger breit unterhalb des Proc. xiph., I 
Schädellage, Schädel im Becken eingetreten, Herztöne 
( + ). 4h. 16.2.1941 Blaseilsprung. 9h. 30 Spontangeburt 
einer männlichen 3200 g. schweren und 50 cm. langen 
Frucht aus H.H.H. 9h. 45 'Spontane Placentaausstossung. 
Unmittelbar nach der PlacentaaBsstossung trat eine 
ziemlich starke Blutung auf, die auf die gewöhnlichen 
Blutstillungsmittel (Pituinal, Gynergen, Uterusmassage) 
nicht aufhört. Puls 130. 12h. Anhalten der Blutung. 
Puls 150. Allgemeiner Zustand schlecht. Mit lücksicht 
darauf entscliliesst man sich zu meiner Uterustamponade. 
Prompte Blutstillung. 17h. Entfernung des Tampons. 
Keine Nachblutxmg. Uterus stark kontrahiert. 26,2.1941 
Nach normalem V/ochenbettverlauf wurde die Wöchnerin 
gesund entlassen. 

Protok. Nr. 624/1941. Frau Z.A., 233ährig, II Gravi- 
dität, I Partus. Letzte Menses am 5#5»1940. 16.2.1941, 
20k. Wehenbeginn. 17#2#194l, 5h. 10, Axifnahme in unse- 
rer Klinik. Geburtshilflicher Befund: Fundus uteri 
4 Finger breit unterhalb des Proc. xiph. I Schädellage, 
Schädel im Becken eingetreten, Herztöne (+). Normale 
Beckenverhältnisse. , 5h30' Blasensprung. 6h. 5 'Mutter- 
mund verstrichen, Blase gesprungen, Schädel eingetre- 
ten, Pfeilnaht/ schräg, kleine Fontanelle links vorne. 
Herztöne verlangsamt, 80 in der Minute. Mit Rücksicht 
darauf entschliesst man sich zur sofortigen Geburts- 
beendi^ung. 6h. lO' Anlegen der Zange und Extraktion 
einer 2200 g. schweren und 49 cm. langen weiblichen 
lebenden Frucht. 6h. 25' Spontane Placentaausstossung. 
Unmittelbar nachher trat eine starke Blutung auf, die 
durch die gewöhnlichen Blutstillungsmittel nicht zu 
beeinflussen ist. Puls 140, allgemeiner Zustand 
schlecht. 7h. Tamponeinführung, worauf die Blutxing 
prompt steht und der Uterus sich stark kontrahiert.' 
12h. Tamponentfernung. Kefine Nachblutung. Puls 110, 
allgemeiner Zustand gut. 26.2.1941, Entlassung nach 



I 

I 



4 

I 



r 



-5- 



Fall 4) 



Fall 5) 



normalem '<Yochenbettverlauf • 

Protok* Nr. 832/1941. Frau E.L., 20jährige Ipara* 
Letzte Menses am 45*5 »1940. 2*3.1941, 19h. Wehen- 
beginn. 3.3.1941, 19h. Aufnahme in unserer Klinik. 
Geburtshilflicher Befund: Fundus uteri 2 Finger 
breit unterhalb des Proc. xiph., I Schödellage, Schä- 
del mit mittlerem Segment ins Becken ragend. Herz- 
töne ^•). 2.3.1941, 20h. Blasensprung. 3.3.1941, 
21h. 5, Muttermund verstrichen. Blase gesprungen, 
Schädel in Beckenmitte, Pfeilnaht q.uer, kleine Fon- 
tanelle links. Beckendurchmesser: 23,26,30,17. 
Temperatur 39 • Puls 95 • Mit Rücksicht auf das Fehlen 
der kindlichen Plerztöne und der Temperatur Steigerung 
entschliesst man sich zur Baseothripsie. 21h. 30' 
Anlegen des Braxin' sehen Kranioklastes womit eine 
männliche 2600 g. schwere tote Frucht entwickelt 
wurde. 21h. 40' Spontane Placentaausstossiing. Unmit- * 
telbar nachher trat eine massig starke Blutung auf 
die die gewöhnlichen Blutstillungsmittel keine #ir- 
kiing haben. Puls 130, allgeiaeiner Zustand nicht gut. 
22h. Tamponeinführung. Aufhören der Blutung, Uterus 
stark kontrahiert. 24h. Keine Blutung, allgemeiner 
Zustand wesentlich gebessert, Puls 110.2h., 4.3.1941 
Tamponentfernung. Keine Nachblutung. Uterus stark 
kontrahiert. 10.3.1941 Entlassung nach normalem 
V/ochenbettverlauf . 

Protok. Nr. 1364/1941. Frau E.A., 30nährige Ipara. 
Letzte Menses nicht erinnerlich. 10.4.191, 22h. 30' 
Wehenbeginn. 11,4.41, 11h. Aufnahme in unserer Klinik. 
Geburtshilflicher Befund: Grav, Mens. IX, Fundus 
uteri 3 Finger breit imt erhalb des Proc. xiph. I 
Schädellage, Schädel im Becken fast eingetreten. 
Herztöne 1+), frühBBitigBr Blasensprung. I4h.15 
Muttermund verstrichen. Blase gesprungen. Schädel 
eingetreten, Pfeilnaht schräg, kleine Fontanelle 
links vorne. Herztöne stark beschleunigt. Mit Rück- 
sicht darauf entschliesst man sich zur ^eburtsbefen- 
digung. 14h. 25' Anlegen der Zange. Entwicklung einer 
männlichen 3300 g. schweren und 50 cm. langen leben- 
den "^rucht. 14h. 30' Spontane Placentaausstossung. 
Unmittelbar nachher trat eine massig starke Blutung 

auf, auf die die gewöhnlichen Blutstillungsmittel 
keine vVirkung haben. Puls 130. Ohnmachtsanfälle. 
15h. Tamponeinführung. Aufhören der Blutung, Uterus 
stark kontrahiert. Puls 100. Allgemeiner Zustand 
wesentlich gebessert. 17.4.41, Entlassung nach Fie- 
berfreiem Wochenbettverlauf. 



i 



r 



n 



-6- 



Fall 6) 



Fall 7) 



Protok* Nr* 1780/1943. Frau P.T*, 22jährige Ipara. 
Letzte Menses am 18.11»1942» Die «VöcJuierin wurde zu 
Hause entbunden (Forceps), sie suchte aber unsere 
Klinik auf wegen der bestehenden Blutung die unmittel- 
bar nach der Placentaausstossung auftrat. Puls 120» 
Temperatur 37 8 • Allgemeiner Zustand relativ gut. 
Die vorgenommene Uterus aus tastung ergab dass der Ute-^ 
rus leer war. Die Revision des Oenitalschlauahes wies 
einen doppelseitigen Muttermund und Scheidenrids auf, 
die durch einige Catgutnähte versorgt wurden. Trotz- 
dem hielt die Blutung noch an. Puls 150, Ohnmächte- 
anfalle. Da die gewöhnlichen Blutstillungsmittel die 
bestehende Blutung nicht beeinflussen konnten, ent-^ohlo 
schloss man sich zur Tampon einfiihrung. Sofort nack 
der Tamponeinführung hörte die Blutung auf. Der Uterus 
kontrahierte sich gut und der allgemeine Zustand dBr 
Patientin besserte sich ziinehmend. Fünf Stunden später 
wurde der Tampon entfernt, und 10 Tage nach der 
Tamponeinführung verliess die Wöchnerin gesund unsere 
Klinik. 

Protok. Hr. 1664/1943. Frau A.P», 24 jahrige Ifara. 
Letzte Menses am 11.11.1943. 21.8»1943, 5h. 30 
V/ehenbeginn. 9h. 30' Aufnahme in unserer Klinik. 
Geburtshilflicher Befund: Fundus Uteri 2 Finger 
breit unterhalb des Proc. xiph.* I Schädellage^ Schä- 
del fast eingetreten, Herztöne (+)• 15h. Blasensprung. 
I6h. Spontangeburt einer lebenden, weiblichen 3250 g. 
schweren und 50 cm. langen Frucht aus H.H.H. I6hl5' 
Spontane Placentaausstossung. Unmittelbar nachher 
trat eine ziemlich starke Blutung auf, auf die die 
gewöhnlichen Blutstillungsmittel keine .Virkung hatten. 
Puls 160, Ohnmachtsanfälle. 17h. Tamponeinführung, 
worauf die Blutung prompt stand und der Uterus sich 
stark kontrahierte. 22h. Tamponentfernung. Keine Nach— 
blutxing. Uterus stark kontrahiert. Puls 120, allge- 
meiner Zustand bedeutend gebessert. 2»9»43, Entlassung 
nach fieberfreiem V/och enb et tverlaxif. 



M 



Nachdiesen glänzenden Resultaten kann ich jetzt mit 
Freuden hier das gleiche sagen, was ich für die Blutstillung 
bei gynäkologischen Operationen gesagt habe, dass nämlich 
mein Tampon bei richtiger Anwendung auch bei schwer zu stil- 
lenden atonischen lutungen nach der Geburt der Placenta eine 
sichere und nie versagende Hilfe bietet. 



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UNITED STATES PATENT OFFICE. 

ETHELBEKT KEAVLEY, OK K08THKRN, SASKATCHEWAN, CANADA. 

CURETTE. 



No. 839,641. 



Speciflcation of Letters Patent. Patented Dec. 25, 1906. 

Application filed December 21, 1905. Serial No. 292,747. 



^ 



• 









2'o (ül ii'fionh it iHdif roricern: 

Be it known that I, Eni elbkrt Keavley, a 
su})jort of tlie Kin^ of Groat Britain, and a 
residcMit of Kosthern, in tho Provinoe of Sas- 
5 katchewan and Dominion of Canada, have in- 
vented a new and lin])roved Curette, of 
whicli tlie followin^ is a lull, clear, and exact 
dcscription. 

The invention rehites to uterine curettes, 

10 ])iit niay he likewise adapted for ciiretting in 
siir<!;ical work. 

Tlie piirpose of the invention is to so coii- 
struct the nistruinent that it will he of niod- 
erately soft or seinipliahle inaterial, i)refer- 

15 ahly riihher, and so that one sliank and lian- 
dle can he conveniently and accuratel}' litted 
to dilferent sizes of the instruinent, and, fur- 
ther, to provide an instruinent that inay he 
safely inserted without iniury to tJie neck of 

20 the woinh and whicli will act to effectively 
reinove placenta or other fetal matter and 
suhstances without laceiatin*^ ui iiillaiiiiii<i^ 
intra-iiterine tissue and without dan<i^er of 
])ro(lucinf^ new lesions and which will be in 

25 all respects inuch su])erior to metal instrii- 
inents now^ used for the purpose or the liiigei- 
of the Operator. 

The invention consists in the novel con- 
struction and combination of the several 

30 parts, as will he hereinafter fully set forth, 
and pointed out in the claims. 

Keference is to behad to the accompanying 
drawings, forming a part of this speciiication, 
in which similar characters of reference indi- 

35 cate corresponding parts in all the iigures. 

Figure 1 is a perspective view of the instru- 
inent complete. Fig. 2 is a horizontal scc- 
tion through the instrument, the shank of 
the handle and the hlade appearing in side 

40 elevation. Fig. 3 is a view similar to that 
shown in Fig. 2, showing a slight change in 
the concavity thereof ; and Fig. 4 is a perspec- 
tive view of the blade-section of the snanK. 
The instruinent A is provided with a re- 

45 movable shank B, having an attached or in- 
tegral handle B', which is usually Hat, as illus- 
trated, and at the outer end of said shank a 
collar 10 is formed, and a hlade 11 extends 
outw^ard froin the shank adjacent to said col- 

50 lar, forniing a Shoulder 12 at what may be 
ternied the ''front" face of the hlade, as is 
shown in Figs. 2 and 3, and, as is illustrated 
in Fig. 4, the longitudinal edges of the blade 
taper inward in direction of the shank, ren- 

5 5 dering said blade widest at its outer end. 



The instruinent A is inade of moderately- 
soft rubber or an equivtilent seiiiiplastic ina- 
terial and is somewhat sj)oon-shaped in gen- 
eral conto ur, The instrument is of greatest 
breadth and depth at its outer end and of 6c 
least such dimensions at its inner end, which 
is circuilar in cross-section. The back 13 of 
the instrument is convexed, and the outer 
end 14 is rounded off, while the front face 15 
is concaved, the convex and the concave sur- 65 
face meeting at an acute angle, as clearly 
shown in Fig. 3, and it may be liere remarked 
that the longitudinal tapei* of the entire in- 
strument is quite gradual. 

A concavity 16 is produced in the front 70 
face 15 of the instrument, which concavity is 
Segment al in the cross-section of the instru- 
ment and gradually diminishes in depth in 
direction of its innt^r end, thereby forming 
side marginal lips 17, continuous with an 75 
outer end marginal lip IT*", the said lips 
forming the scraping edge of tlu curette. 1 
desire it to be understood that the instru- 
ment A mav be ihade in dilferent sizes, and 
the concavity 16 may be made deeper or 80 
shallower than shown, and shorter or longer, 
as demanded by the Service required of 
thein. 

All sizes of the instrument are provided 
with a longitudinal slot 18, which extends 85 
outward from a circular opening 19 in its in- 
ner end. The slot 18 terminates sliort of the 
outer end of the instrument and is practically 
on a liiie dravvn about centrally and longitudi- 
nally through the instruinent, as is shown in 90 
Figs. 2 and 3. The slot 18 receives the blade 
11 and the circular opening 19 the onter end 
of the shank B and its collar 10. The blade 
11 does not extend to the outer (^nd of the 
body of the instrument, in order that the 95 
flexibility of the instruinent shall not be in- 
terfered with at such point, and the blade 
11 is oÜ'set to the rear in order that it will not 
be too close to the inner end portion of the 
concavity 16 and yet permit the shank to sus- 100 
tain a central position relative to the instru- 
ment. 

The rul)ber instrument is far superior to 
steel, as the moderately-soft rubber will not 
lacerate the inflamed intra-uterine tissue and 105 
thus produce a new lesion through w liich tlie 
geims would still fürt her invade said tissues. 
It is superior to the iinger because longer, and 
by its use all parts of the uterine cavity are 
easily accessible. Again, when using the uo 



r 



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13 



830,641 



ID 



finj^er it is necessary to dopress the inllaiiied 
Uterus a^ainst the iiii<;er, and such pressure 
call be eniployed only wheii usm«^ an anes- 
thetic, if niuch tenderness be ])resent. The 
pressure apphed to the uterus throu^^h the 
abdominal treatnient aggravates the pain 
and produces a further extension uf tlie in- 
llainiuation. Furtherniore, all risk of per- 
forating the softened uterine tissue is very 
greatly reduced, if not absolutely abolished. 

Having thus described niy invention, I 
claini as iiew and desire to secure l)y Letters 
Patent — 

1. A curette coniprising a rigid shank pro- 
15 vided with a llattened and wiclened end, and 
with an annular Hange at the junction of the 
shank and ihe ilaliened poriiori, and a body 
portion of flexible niaterial having a slot for 
receiving the flattened end, and an annular 
groove for receiving the Hange, said body 
portion being provided with a concavity hav- 
ing a scraping edge for the j)urpose set forth. 



20 



2. A curette coniprising a rigid shank, and 
a flexible body portion, said body portion 
having in the siüe thereof a concavity pro- 25 
vided with a scra])ing edge for the pur])ose 
set forth. 

3. A curette coniprising a rigid shank, and 
a flexible body portion or blade provided in 
one of its faces with a concavity, the sur- 30 
faces of the concavity and the body portion 
nieeting at an acute angle to form an edge 
for the purpose set forth. 

4. A curette coniprising a rigid shank, and 

a blade having a flexible edge for the purpose 35 
set forth. 

In testimony whereof 1 have signed my 
name to this speciiication in the presence of 
twu suusci'ibiiig wiiiicööco. 

ETllELBEKT iiEAVLEY. 

Witnesses: 

Susan Ckaig, 
G. A. McHuGH. 



l 



\ 



DEUTSCHESjRElCH 




AUSGEGEBEN 
AM 3. NOVEMBER 1933 



REICHSPATE^TAMT 

PATENTSCHRIFT 

--JVr 362^97 - 

KLASSE 30 a 4'^UPPE 11 



APR 14 1923 
^' Patent Q^' 



ir 



Dr. Paul Klaac in Wien. 

Gegen Perforationen sichernde Cürette. 
Patentiert im Deutsclien Reicfce vom 27. April 1921 ab. 



Für diese Anmeldung ist ^emaa dem Inionsvertrinc vom :. Juni lyii die Priorität auf (Jrund 
der Anmeldung in Österreich von^ i8. Januar 1921 beansprucht. 



^ Die bisher in der Fniucnheilkunde verwen- 
deten Instrumente zur Entfernung von 
Kesten, die bei vorzeitigen oder normal ver- 
^laufenden Geburten in der Gebärmutter zu- 
5 rückbleiben, sowie zu anderen therapeutischen 



i 

Zwecken, wie etwa Auskratzungen der Ciebär- 
(mittersclilcinihaut wegen Entzündungen usw., 
laben in bezug auf ihre Verwendung verschie-^ 
Icne Nachteile. 
So besteht stets die Gefahr, daß bei der Be-^ 10 



^ 



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50 



55 



nutzung der bekannten Cüretten bei EinfuhT 
rung in die Gebärmutter, selbst wenn dies 
unter Führung der Finger geschieht, die Wan^ 
düng der Gebärmutter durchstoßen wird; denn 
die Wandung des Organs hat infolge der vcr^ 
schiedenen abnormalen Veränderungen keinen 
großen Widerstand. Demzufolge kann man 
mit den derzeit gebräuchlichen Cüretten 
tiefer eindringen, was die Perforation der 
\^andung und damit gefährliche Folgen und 
selbst den Tod der Patientin zur Folge haben 
kann. 

Es muß deshalb vor Einführung der 
Cürette mit Hilfe eines Meßinstrumentes 
(graduierte Sonde) die Tiefe der Gebärmutter 
festgestellt werden. Trotzdem ist aber für 
den Operateur, kein Mittel gegeben, ein zu 
tiefes Eindringen mit der Cürette beim nach- 
folgenden Arbeiten hintanzuhalten, weil er 
t)ei der Auskratzung oder Abschabung wieder- 
holt sehr verschieden große Widerstände zu 
überwinden hat und daher das Gefühl für ein 
2U tiefes Eindringen bzw. Durchstoßen zu- 
folge der Weichheit der Wandung naturgemäß 
verliert. 

Das den Gegenstand der vorliegenden Er- 
ng bildende Instrument beseitigt die ge- 
Nachteile und schließt jede Gefahr 
Benutzung dadurch aus, daß eine 
irgendeiner der bekannten Aus- 
mit einer gleichzeitig das Ein- 
^ enzendcn Stellvorrichtung in 
gebracht ist, wobei der Abstand 
dem arbeitenden Kopfstück der 
ürtd dem an den Scheidenteil der Ge- 
:er anstoßenden Teil der Stellvorrich- 
der jeweils durch die Sonde fest- 
Eindringungstiefe jederzeit vorher 
werden kann. 
Zeichnung veranschaulicht in Abb. i 
firette, in Abb. 2 die an dem Cüretten- 
angebrachte Stellvorrichtung. Die Abb. 3 
4 stellen das gebrauchsfertige eingestellte 
Instrument in zwei zueinander rechtwinkligen 
Ansichten dar, wobei in Abb. 4 ein Hohl- 
körper gezeigt ist, in welchen das Instrument 
auf eine begrenzte Tiefe eingefiäirt erscheint. 
Die Cürette a hat die gebräuchliche Form 
und einen stumpfen oder scharfen Kopf teil; 
sie ist zwecks Einsetzens in ihren Griff b mit 
einem Vierkant a versehen und wird durdl, 
eine Schraube c in der Hülse des Griffes fest- 
grfialten. Die mit der Cürette in Verbindung 
zu bringer*de Stellvorrichtung besteht aus 
einem Rohr d zur Aufnahme des Cüretten- 



stieles, der als Führung für die an ihm 
schieblwre Stellvorrichtung dient, ru w< 
Zweck das Rohr d eine nach hinten re 
Schlitzführung f besitzt, die an einem 
kel ^ an der Griffhülse sich führt und njittel^ 
einer Stellschraube h am Griff h festgi ' 
werden kann. 

Das vordere Ende dea Rohres d tri 
|)lattenförmiges Querstück i, welches, 
Abb. 4 zu ersehen, infolge seiner Brei 
dehnung am Eintritt in den verengten , 
artigen Scheidenteil der Gebärmutter." 
hindert ist, wogegen das Kopf stuck 
Teil des Stieles der Cürette, der at 
Rohr d der Stellvorriditung vorst« 
gehindert durch den Scheidenteil hfinc 
die Gebärnnitterhöhlung eingeführt 
kann. 

Nachdem mittels der Sonde die T« 
Körperhöhlung, in welcher die Auskrj 
vorgenommen werden soll, bestimmt w^ 
ist, wird die Cürette in dem Rohr dcf 
Vorrichtung auf die an der Sondensl 
mittelte Länge eingestellt und die St< 
richtung am Cürettengriff mittds 
Schraube h festgestellt Nunmehr ii 
Abstand zwischen dem Cürettenkopf« 
der Querplatte » gleich der zulässigen 
dringungstiefe des Instrumentes g( 
und dieser Abstand bleibt nach der diti 
Querplatte begrenzten Einführung 
der ganzen Dauer der Arbeit unvi 
aufrechterhalten, so daß ein sicheres 
des Operateurs gewährleistet ersehe'*»* 
der Widerstand, den die Querplatte _.. 
Scheidenteil der Gebärmutter findet, e' 
bedeutender ist, so erscheint dadurcÜ 
tiefes Eindringen der Cürette aiit 

Da das Instrimient leicht zerle^)ar U 
die sorgfältige Reinigimg ebenso leidÄ 
rasche Austausch der Cüretten vorg< 
werden. 

Patent- An SPRUCH 

Gegen Perforationen sichei 
gekennzeichnet durch eine 
tung, die aus einem an dem 
stiel verschiebbaren und am Gri 
rette feststellbaren Rohr bestellt, lin- 
dem Cürettenkopf zugekehrten ^' 
Querstück angebracht ist, welche* ... 
führung der auf die Tiefendisti 
behandelnden Körperhöhle aus 
Vorrichtung vorragenden Cürette^ 



M*.j. 



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K£:puBLiQte Fii\NgArsB. 



MINISTKÜi: DU commerce: et de L'INDUSTRIE. 
ÜiRKCTIOiN DE LA PROPtlETE INDUSTRIELLE. 

■»♦<r-f 

BREVE T DmIvENTION. 



Gr. 19. —ia. 1. 



r 734.439 



Curette pour räclages ut^rins. 

M. Adam Maksymiuan PAPKE n'sidanlcii Poloyne. 

Demand6 le 17 mars 1932, ä 14*» 34" ä Paris. 
Dt'livn'; le i'^aoiit i()39. — Pi^bli^ le 9i oclobre tgSa. 

I^|)«'nian<le de brevel d^pos^een Polognc le i6 j^in 1981. — D<^lai*alion du deposanl.) 



Oll siil ([n'''!! iii«'<1fH-i!i(» cliinirirical«' on 
(>t fmuH'iiiiiH'iit <>l.li<i('. ."1 hl >-uit(' «riiii no- 
cuiicluMiHMit. <!(' f:iii'(' UM ciirj'ttüjic «Ic \'n\v- 
i'U- iMMir ('II ('liiiiiiicr Ics «IrUris nliiccntjiiros, 
\ ccttc »''liiiiiiiMtioii rtaiit i»i:iti(iu<''C'( le plus 
Hiuvciit cji j(;irtic M l;i iiuiiii et cn partic a 
J'aidc «l*u|^«' ciin^ttc a iikiik-Iu' raide. ccllcM-i 
«'taut iii«li.>iK'iisal>l<' tfUHcs Ics fois i\\w los 
<i(']ii-is |»la<'('iitair('s adlirrcut cucorc fortc- 

,Q iiiciil aux pariiis de Tutorus. 

l/<'iiijd(ii de la curette a iiiau(die raidc 
• ti'diiiaiie a riiKMtnveiiiciit dtuTasidinicr 
:\>M'y. suiiveiit iles lesioiis des pands de Tute- 
ni> fataleiiieut raniollies au i'ours de Tac- 

l5 <''U(du'iueiit. 

l.a pre-scnte inveiiti(ui a pour ohjet nnc 
'U rotte (d)viant a (-«'t incoiivenient (»t ro- 
1! anpialde eii ce (pi'cdle peilt otro entiero- 
iiH'ut ronfeniioe <laiis lu uiaiii du uiedeoin 

20 <'ii du (diinir<jieii au niouieiit uu <dle est 
introdiiite daus Tutorus do rao^^-oiioliee. 

Cettc iiouvelie curette constitue im inatru- 
nieiit moiiis daiif::ereux que le?^ curette.s 0111- 
p]oye<^s jus(pi'a prescait et periuet <1e siip- 

2 prijiier les diverse?^ (Operations iiiaimelk^ 
buivie.s d'uu curettag<' iiistruin(»ntaire neees- 
.sitees auterieureiiient et de reduire le ra- 
ola^<' di*s |»an)is iiteriiios a uiio nperatu'ii 
iiuuuiolle uni(jue .saus les Ulessor. 



|l)ans le de^t^in aniiexe : 3o 

Fig. 1 est une vuo de cote de la iiouvelle 
(11 rotte; 

V\iX. 2 on <»st la vue de face. 

;i/instruinent se comiMwe (l'une curette 
j ropreniont dite 3 jx)ur raclage uterina, Z% 
f.xoe sur iin manche recourbe court 4 con- 
stitue par un metal ou une matiere assez 
flaxible j)our etre cint-ree et adaptee a la 
inain de l'operateur. Ce manche 4 est ter- 
inine par un renflc»ment arnmdi 5 destine ä &o 
vebir b*aj)puyer contre le centre du creux 
nesa main {wnir assurer la fixite de l'instru- 
ment au cours du curettage. 

te manche 4 eöt relie par un petit pont 
2 a un anneau 1 destine ä s'enfiler sur le 45 
doigt median de Toperateur. Une fois Tan- 
nejiu 1 maintenu de cette fa^on, le renfle- 
miit 5 correspond au centre du creux de la 
miiiii tandis que les bouts de« doigts sont 
po^es en dehors du bord superieur de la 5o 
curette 3. 

iLa technique du curettage effectue ä 
Taide de cet instrument perraet de decoUer 
le^iresidus placentaires qui adherent forte- 
mffit aux parois de l'uterus et qu'on ne 55 
jx^rrait decoller ä la main. Corame lee 
]'(.Äts des doigts se trouvent au-dessus de 



i. 



•iutree coustituant la curette pro- 



1 



Prix du fascicuTe J 5 francs. 



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.1 D 



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[734.439] — 

prement dite, IIb controleut tactilement Hi 
tin d^bris placentaire quelconque adhere 
aux papoiß de rut^nw. 

En outre, le curettage op^re ä Taide de 

o cet inatrument donne k Top^rateur une phw 
grande aüret^, en ce sens qu'en oontrolant 
par le boot de ses doigts le mouveniPiit dp 
la curette, il evite de bleaser les parois ra- 
mollies de Tutenw, tout eii alliant 1«» avaii- 

o lages du curettage manuel et du curetta^e 
inatnunentaira 

Curette pour raclages uterinF, remarqua- 



ble en ee quVll«. sc vuni\>c,M' ,l'u,.(. curpttc 
proprenicnt dite prolonpeant in, mam-ho re- iS 
ccuirbe tennine a hui pxtn'init«' lihro par un 
renflomeiit arrondi, cc manche otjint avan- 
tageuaement flexible p^mr sc rourber et 
arwez c-oiirt [Knir Hro lo«r,' (•(.rupl^tcniont 
dans la niain cn iiM'mc tfinps (juf la curette 20 
au manche ('taut {»rpfprablciiMMit rclip par 
un petit pont im aiinpau .s'nitiJant siir un 
doigt de r«q>erateur. 

ADiM Maksymiuan PAPEK. 

Par pr«rv*Uoa i 

Mavltadlt. 



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Blutung nach der Geburt der Plazenta. 



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Sonderabdruck aus dem Zentralblatt für Gynäkologie 1933 Nr. 14 

Aus dem Anatomischen Institut in Athen 
Direktor: Prof. Dr. G. Sklawunos 

Anatomische Ergebnisse der Blutstillungsmethode 

nach Logothetopulos' 

Von Dr. Ch. Christopulos, 

Assistenzarzt an der Gynäkologischen Universitätsklinik in Athen 

Als vor 2 Jahren der Professor der Anatomie in Athen, G. Sklawunos, bei 
einer Operation die Blutstillungsmethode nach Logothetopulos anwenden sah, 
fand er es zweckmäßig, diese Methode einem Studium zu unterwerfen und sie auch 
an Leichen anzuwenden. Darauf wurde ein Assistenzarzt der Gynäkologischen 
Klinik, Dr. Ch. Christ opu los, beauftragt, diese Untersuchungen im Anatomischen 
Institut unter Aufsicht von Prof. Dr. G. Sklawunos auszuführen. 

Diese anatomischen Untersuchungen bezwecken einerseits die Feststellung 
der Art der Wirkung des Zugtampons, andererseits die Bestimmung der Lage und 
des Verhältnisses desselben zu den Organen des Beckens. Die Untersuchungen 
wurden bei fünf einbalsamierten Leichen ausgeführt. Es wurden 3mal vaginale 
und 2mal abdominale Totalexstirpationen vorgenommen. Es muß hier betont 
werden, daß sowohl die abdominale, wie auch die vaginale Anwendung der Tam- 
ponade und der Zug der Gazezipfel bei allen Fällen genau so ausgeführt wurde 
wie bei Lebenden. 

Bei allen Fällen wurde die Einspritzung von Farbstoff in die Carotis den 
2. — 3. Tag nach Anwendung des Tampons vorgenommen. Die Eröffnung der 
Leichen wurde am 8.— 12. Tag gemacht; die Beckenhöhle wurde freigelegt durch 
einen Längsschnitt in der Mitte und zwei anderen senkrecht auf dem ersteren 
verlaufend. 

I.Fall. Abdominale Totalexstirpation des Uterus mit Hinterlassung der 
Adnexe. Die A. uterinae werden nicht unterbunden. Die Eröffnung des Leibes 
erfolgte den 8. Tag nach der mit der Operation verbundenen Tamponade. Nach 
Freilegung der Beckenhöhle sehen wir das Netz auf den Därmen liegen und die- 
selben wieder auf dem obersten Teil des Tampons. Nach Verschiebung der Darm- 
schlingen nach aufwärts sehen wir, daß der oberste Teil des Tampons 4 cm nach 
vorn oberhalb der Symphyse reicht, hinten in der Höhe des III. Sakralwirbels 
und seitlich in der Höhe der Linea innominata und im Verhältnis zu den Iliacal- 
gefäßen 3 cm unterhalb der Teilung der Iliaca comunis. 

Der Douglas'sche Raum ist trotz des starken Zuges der Gazestreifen hinten 
frei, so daß man leicht mit dem Finger bis zum Beckenbogen kommen kann. Das 
Sigmoideum sowie das Rektum sind in ihrem ganzen Lauf vollkommen frei. 

Der größte Druck wird außer auf die seitlichen Beckenwände hauptsächlich 
auf das Trigonum urogenitale ausgeübt. Der rechte Eileiterstumpf wird gedrückt, 
der linke liegt höher und ist infolgedessen frei. Wir nehmen den Tampon heraus 
und sehen, daß die Höhle, in welcher der Tampon lag, umgeben wird von der 
Blase, dem Mastdarm und dem Trigonum urogenitale, welches nach vorn und 
unten leicht verschoben ist. 



» Vortrag, gehalten von Prof. Dr. K. Logothetopulos in der Gynäkologischen Gesell- 
schaft in Wien am 20. XII. 1932. 

807 



» >■# ■ 



1 



4 



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Zentralblatt für Gynäkologie 1933 Nr. 14 

Wir tasten die Höhle aus und finden, daß sie als feste Unterlage die innere 
Fläche des Os ischii hat. Darauf schreiten wir zur anatomischen Präparierung 
der Gefäße des kleinen Beckens. Zu diesem Zweck spalten wir das Becken in der 
Schamfuge. Nach der Freilegung der Gefäße der linken Beckenhälfte sehen wir, 
daß alle Äste der Arteria hypogastrica von Farbstoff gefüllt sind. Wir verfolgen 
speziell die Arteria uterina, welche bei der Operation nicht unterbunden wurde. 
Dieselbe ist oberhalb der Schnittstelle in einer Länge von 2 cm frei von Farbstoff. 
Daraus schließen wir, daß gerade auf diese Stelle der Tampon einen großen Druck 
ausübt. Aus den Kapillargefäßen merkt man keinen Austritt von Farbstoff. 

2. Fall. Vor der Operation und Anwendung der Tamponade und 6 Tage nach 
der Einbalsamierung der Leiche wurden die Gefäße mit einer Lösung von Sproz. 
Natrium citricum durchgespült, um dieselben von eventuell vorhandenen Throm- 
ben zu befreien. Die Operation bestand in der vaginalen Totalexstirpation des 
Uterus mit Hinterlassung der Adnexe. Bei der Anlegung des Tampons wurden die 
Stümpfe der Eileiter etwas heruntergezogen, die Klemmen sind jedoch entfernt 
worden, ohne die Gefäße zu unterbinden, die Arteriae uterinae sind durchschnitten 
worden, ohne überhaupt angefaßt zu werden. 

Die Eröffnung der Leiche wurde am 8. Tage vorgenommen, nach der Ein- 
spritzung des Farbstoffes durch Herausschneiden der ganzen vorderen Bauch- 
wand. Das Netz und die Därme liegen auf dem Tampon, genau wie in dem 1. Fall. 
Ein Stück von dem Dünndarm liegt hinter dem Tampon tief im Douglas'schen 
Raum. Nach Herausziehen der Därme sieht man den Tampon, der eine ovale 
Form hat und dessen Oberfläche etwas unregelmäßig ist. Die Harnblase ist leer 
und liegt auf dem Tampon. Rechts hat das parietale Blatt des Peritoneums wegen 
des Zuges des Adnexstumpfes nach unten eine Falte gebildet, welche ungefähr 
im V. Lendenwirbel anfängt. Links sieht man nur die Falte des Lig. latum. Beider- 
seits sitzen die abdominalen Teile der Eileiter auf den Seitenflächen des Tampons. 
Der Stumpf aber des Eileiters liegt unter dem Druck des Tampons. 

Wir wollen feststellen, inwiefern die Tamponade drückend auf die Ureteren 
wirkt, zu dem Zweck legen wir den linken Ureter vollkommen frei und eröffnen 
ihn etwas über seiner Kreuzungsstelle mit den Iliacalgefäßen. An der Eröffnungs- 
stelle spritzen wir unter schwachem Druck mit einer Spritze etwas Wasser ein. 
Das Wasser tritt ungehindert in die Blase ein. Bei der Füllung der Blase wird die 
Dehnung derselben nach oben nicht gehindert, nur ein leichter Druck der gefüllten 
Blase wird im unteren Teil derselben bemerkt, und zwar nur, wenn die in die Blase 
eingelaufene Flüssigkeit 300 g überschreitet. 

Wir vergrößern den Zug der Gazezipfel, die vor der Scheide liegen, auf das 
höchste und führen auf die gleiche Weise Flüssigkeit in den rechten Ureter ein. Trotz 
des großen Zuges wird bei dem Durchlaufen der Flüssigkeit durch den Ureter kein 
Hindernis bemerkbar. Nach Einlaufen von 200 g Flüssigkeit in die Blase drücken 
wir auf dieselbe, worauf die Flüssigkeit sich durch die Harnröhre entleert. Daraus 
schließen wir, daß trotz des starken Zuges kein Druck auf den ganzen Verlauf 
der Urethra ausgeübt wird. Der Tampon wird entfernt, wir präparieren die Gefäße 
des Beckens und finden, daß die A. uterinae 3 cm lang oberhalb des Schnittes 
keinen Farbstoff enthält. 

3. Fall. Vaginale Totalexstirpation des Uterus ohne die Adnexe. Es wurde 
kein Gefäß unterbunden. Folgende Tamponade. In diesem Fall wollten wir den 
Druck feststellen, unter welchem der Farbstoff aus der Spritze in die Carotis ein- 
drang. Zu diesem Zweck vereinigten wir den einen Teil der T-förmigen Röhre 

808 



'4«n 



'«1 



i 



Christopulos, Anatomische Ergebnisse der Blutstillungsmethode 

mit der Carotis, den anderen Teil mit der Spritze, die Farbstoff enthielt, und den 
dritten Teil mit einem Quecksilbermanometer. Dieser Teil wird mit einer Klemme 
geschlossen gehalten. Sobald wir anfangen den Farbstoff einzuspritzen, nehmen 
wir die Druckklemme weg und lassen den Farbstoff mit dem Manometer in Be- 
rührung kommen. Der Druck steigt dauernd, und erst nachdem er 750 mm über- 
schritten hat, zeigt sich der Farbstoff in den Beckengefäßen. Am 8. Tag nach der 
Einspritzung des Farbstoffes wird die Leiche geöffnet. Nach dem Herausziehen 
der Därme sehen wir die leere Blase auf dem Tampon liegen, genau wie bei den 
vorher beschriebenen Fällen. 

Der Tampon wird herausgenommen und man sieht auf seinen seitlichen 
Flächen die Abdrücke, die die gedrückten Adnexen hinterlassen haben. 

Die Stümpfe der Eileiter befinden sich auf den seitlichen Wänden des kleinen 
Beckens. Wegen des nach unten gedrängten Beckenbogens ist der Scheidenstumpf 
nach unten zusammengefaltet, ein Zeichen des ausgeübten Druckes des Tampon- 
halses. Nach dem Durchspalten des Beckens werden die Gefäße präpariert und 
wir bemerken, daß trotz des verhältnismäßig kleinen Druckes, unter welchem der 
Farbstoff eingespritzt wurde, alle Äste der Hypogastrica gefüllt sind. 

Wir verfolgen die Aa. uterinae und präparieren sie sorgfältig. 3 cm von der 
Schnittstelle befindet sich wegen des auf diese Stelle ausgeübten Druckes kein 
Farbstoff. Ebenfalls befindet sich kein Farbstoff in den Kapillargefäßen der Um- 
gebung. Auf die Harnröhre, Blase und den Mastdarm ist kein Druck aus- 
geübt worden. 

4. Fall. Vaginale Totalexstirpation des Uterus. Kein Gefäß ist unterbunden. 
Tamponade. — Bei der Eröffnung der Leiche durch Mittel- und Querschnitt be- 
finden sich die Grenzen des Tampons etwas höher als bei den bis jetzt beschriebenen 
Fällen. Die Harnblase ist leicht nach rechts verschoben. Der herausgenommene 
Tampon hat wie gewöhnlich eine ovale Form. Der Grenzunterschied derselben 
ist auf den gefüllten Mastdarm zurückzuführen. Das Becken wird gespalten und 
wir bemerken, daß trotz des gefüllten Mastdarms wenig Druck auf ihn ausgeübt wird. 

Beide Eileiterstümpfe sind auf die seitlichen Beckenwände gedrückt. Wir 
präparieren die linke Beckenhälfte. Wir sehen, daß die A. uterina in der Länge 
von 2 cm vom Schnitt aus ohne Farbstoff ist. 

5. Fall. Abdominale Totalexstirpation des Uterus ohne die Adnexe. Unter- 
bunden sind nur die Adnexstümpfe. Die Grenzen des Tampons sind genau wie 
bei den anderen beschriebenen Fällen. Die unterbundenen Stümpfe liegen hoch 
und werden nicht von dem Tampon gepreßt. Blase und Mastdarm sowie Sigmoideum 
sind frei. Der Scheidenstumpf ist wegen des auf ihn ausgeübten Druckes zusammen- 
gefaltet. Die Präparierung der Gefäße zeigt, daß alle Farbstoff enthalten, außer 
an der gedrückten Stelle der Aa. uterinae. 

Aus den beschriebenen anatomischen Untersuchungen ergibt sich, daß die 
Blutstillung durch die Tamponade nach Logothetopulos vollkommen sicher ist, 
und wie sich auch klinisch nachweisen läßt, wird auf kein anderes Organ ein 
irgendwie schädlicher Druck ausgeübt. 

Die Nekrosen der Gewebe sind leicht zu vermeiden durch das Abnehmen 
der vor dem Pessar liegenden Klemme, 8 Stunden nach der Operation, wodurch 
der Druck aufhört. 

Damit auch kein Druck auf die Blase ausgeübt wird, führt man während 
der 2 ersten Tage einen Dauerkatheter ein, damit die Blase dauernd leer ist. 



809 






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pifoiv, £ti bt TrrpioaöTcpov vdt npoSünEV £(<; 
XaTtapoTonfiv TTpac; drv'ai;nTTioiv alpoppooCvroc; 
dtyyflou» 

'EnioTiq ö iv Biiwr\ KaBriyiiTfiq pQ^I Wer 
per »1^'^« ToO Julius Sederl (2) irtpiypäccpov. 
TEc; Eiq TÖ VEOJOti ^köoGev ßiSXiov twv tiq 6 
ocXISok; het' eikövojv Tfjv ^e8o&öv hou, ypdt- 
^ouv tni TOU ocCiToO aimslou Tdt ti,r\c: «"OXwv 
TÜV BuOKOXlÖV TOUTCJV dcTtTiXXdtyriuEv ofjjAEpov 
5idt TTiq ^Ev<*^o<t)uoG<; ix£665ou toO "EXXrjvoq 
FuvaiKoXöyou K tjvoxavTlvou AoyoeEToiioOXou. 
'H |iE6o5oq aüTTi ^löcq ämTp^nEi TxdvTOTE koi 
eI<; öXa«; Täq ■hepitttcöoek; vdt oTa^aTr|0£onEV 
EVTöq ÖXlycjv Xetctcüv Ti]q cjpaq ndcoav aijiop- 
paytocv dcoit>aX.Cüq. Aäov iräq x^ipo^^PVÖ«;, ö- 
oTiq G^Xei ^v itdori f)p£(il<jc vä ^kteXeoq koi 
&(JOKoXov ETI tyxElpTloiv, vä yvcjpi^T) tf\v yit- 
O060V TaüTtiv». 

'H ii^6o5oq dKTEXEiTai xaTd töv dnöXou- 
6ov Tpöitov: nXTjpoG|iEV KaXcjq odKKOv ek te- 
Tpoycjvou Y<5t^^<; 5iä ^anpäq XüjpiBoq yd^riq 
oüTwq, tJoTE va oxnM<*'^iö9B a<|><xipiKÖ(; öyKoq 




viaq TOU TETpaycjvou yd^n«;, cbq kai tö H£« 
Ta^u ToüTtjv dKpov Ttic; Xupiboq yä^rjq, ö- 
TiEp Tipö«; öidKpioiv bto\ vä Etvai KaTd Ti 

^aKpÖTEpOV TCJV TfOOdpCJV äKpuv, OUXA^a^' 

6dvo(icv öyioü 5iä ^idq dyKiaTpoipdpou (iilXriq 
"^o^ Ammoi»' ^^ ö6nyoönEV, ^Exd Tfiv di|Kxi- 
psoiv TTjq nf)Tpaq. dnö Tirjq KOiXiaKT]«; koiXö- 
TT^TOc; biä (lEOOu Toü KöXitou npöq Td ^^CJ yEV- 
vriTiKd öpyava. "O ß0T]6öq ouXXaixftdvEi toö- 
Ta Kai ^Xkei lox^pw«; ixpäq Td KdTcj (x^xP*^*^ 
oO Tö o<jK3tipiKÖv Tannöv eIoeXGh Elq Tf]V t- 
Xdooova txüeXov Kai &uvT]6g vd doKrjoQ ni£- 
oiv im Ttöv dyyfiwv. Tö toioutov ^TxiTuyxä- 
vtTai Kai 61' Eioayuyiiq 6id tou koXeoO \k<x- 
Kpdq KupTrj«; al^ooTaTiKnc; XaSiboq, i^Tiq d^a 
dtva<t>avfj eIq t^v ntpiTovaiKfiv KOiXöTiiTa 61- 
cvoiyETai Kai ouXXajiidVEi Td eI<; aüTfjv eI- 
oayönFva dKpKx xou Tannöv Kai 2Xkei itpöc; 
Td E^u. Ka6' öv xP^vov ö ßorieö«; ^Xkei, ö 



KaiaapiKri Topii. Aiavoi^K kdiXiokuv 
TOixcopdTuv Kai MnTpaq 

ttEplnou KE<paXrj<; ä^6püou. Tö ^^yE9o<; tou 
Tc^itöv E^apT&Tai iK Ttiq 6£oE(oq tou al^iop- 
poouVToc; dyyEiou, Efvai 6^ Töaov uEyaXuTE- 
pov, öoov ItEpiOOÖTEpOV ATt^x^i TÖ dyyEiov d- 
nö TOU nucXiKoO ^öd^ouc;. Tdw; Täoaapaq yu- 

(1) Eric Weber : Techniques chirurgi' 
coies vaginales. Editeur Baillöre et Fils, Po- 
'is 1948. 

(2) Univ. Prof. P. Werner, Dr. J. Sede'i: 
Die Vaginalen - Bauchhoelen Operotionet- 
Wien 1952. Urban und Schworzenberg. 

cHAIOI> 




Eicraywyn toü Ta^irbv meto xfiv ä^aipE- 
aiv TOÜ CM^PÜou. 

Xcipoupyöq cnoSoTieEi Tti^i^tüv ^k tüv dvcj Kai 
5iaKpaTtov tö TajiTtöv ßadEuq ivtöq x^q iiut- 

XOU HEXPiq ÖTOU TOUTO T£X£lCi>q OTEpECoOrj. Tö 

ToioüTov iftiTuyxdVETai (bq diKOXoOetoq: "EX- 
KO(iEv Tä ä^u TOÜ koXeoO KpE^d^EVa dKpa 
ToG Tannöv 6id ^äoou fevöq ^lEydXou 6aKTuX.i- 
oEi5ouq TTEoaou öv üOouiiev 5id TT\q dpioTE- 
pdq x^iP<^<; ^"i foö alSolou. ivü f| ÖE^id x^iP 
jiETd ÖuvdnEcjq CXkei Td dKpa Tfjq ydt4n<;. *A- 
KoXoOGcjq dXXoq ßoT]9öq tottoOexeI laxupdv 
Xafilöa drKpiSüq npö tou ^ieooou, öaTiq f\br\ 
EÜploKETai nETa^u alöolou Kai Xaftl6oq 'H 
aliioppayla ditloxETai ndpauta, nETd Tf|v dt- 
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9a vd £^aKoXou9f]Oü)nEV Tfjv iyY^eipi\a\.v tv 
n&ar\ t\P£\iiq. 

npöq äitioxEaiv aliioppaylaq ^irl KoXniKüv 
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Ttov, (iE Tf|v 6ia(^opd(v öixcoq öTi npöTov Elod- 

yCUEV Töv KEVÖV OdKKOV 6lä H^OOU TOU KOX- 

•niKou TpaünotToq ^iTöq Ti^q TtEpiTova'iKfjq Koi- 
XöTpxoq, 6iä oteiXeoO f[ ^aKpdcq dtvotToniKiiq 
XaSi5oq Kai dKoXo06ü)q nX^poü^iEV töv oäK- 
Kov bid ^axpäq Xu>pi5oq ydijriq. 'Ek Tiap^ \- 
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OEiq ^vTöq XTiq nuEXiKijq KOiXöxi^xoq. oöxioq cj- 
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H0p(|)f|v nfjKuToq (griechenpiiz), ^^ tö «vöiia- 
o£ ö KaOTiyTiTfiq tv AEnplg (SeHheim)- npöq 
äno<puyt|v VEKpüoEcov, aiTiVEq 6uvaTöv vd 
TtpoKXn9oöv (bq iK Tijq loxupäq mäottaq toO 
nEoooü inl TOU alöolou, Toiio9£Toü|iEv ^Exa^u 
TiEooou Kai alöolou Kax* d^^öxspa xd nA-d- 
yia ToO (iloxou tou Tanitöv (iixpöv oTpc.>(ia 
^ä|i£aKoq. Aid töv ocötöv Xöyov f| npö toO 
TitoooO Toiio9ETounävT) XaSlq ditKzipcixai |i£- 
Tä 8 üpaq. Plötq ö(i(>>q nEpaiT^pu x^ipi<'l**<i 
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pou^^vou TOU teXeutoIou jiETä 24 cjpaq. 'Atiö 
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TiTTjq fm^paq, Ahötc d<|>aipoOtiEV (boaüxbiq Kai 
Tfjv ^^(oTEpiKfjv yd^av tou Taniiöv. 

"Iva öiantoTuSg fj ^v^pyEia toO xPloi^o- 
Tioiouii£\ou TojiTiöv d^' ftvöq Kai Iva naOopi- 



oG^ f| 6£oiq aüTou iv ax^oti npöq Td öpya\a 

Ttjq nUEXou dcp' tTEpou, Tfj 0TtOÖEl£;El TOU Ka- 

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vaiq 'AvaToiitiov imö toO N. XpioTonoüXou 
LpEuvai dnl 5 nTtondxtov (3) 'Eydvovxo Tpti<; 
KcXniKai Kai öuo KOiXiaKal OoXEpEKTo^al, 
Ka9' äq i<pr\p[iöaQr] tö Tafinöv dKpificJq dx; 
ini ijcjoiiq yuvaiKÖq, äveu dnoXivüoEojq Tcov 
HTjTpialcjv dcyyElcjv. AOo Eioq TpEiq fjjx^paq 
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^dTGJV, blE1TlOTCJ9TJ bt ÖTl TÖOOV TÖ dnEu9i»« 

an^vov, öoov Kai f| oüpoSöxoq KüoTiq jicTd 

TWV OÜpTJTTJpCJV EKFlVXO E^(o9l ToG UTTÖ nlEOlV 

eOpiOKOn^vou TtFÖiou, dmoKXEioGelaTjq oütgj 
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xcjq öiemoT(i9Tj öTi ol loTol n^pi^ twv öia- 
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atutq, npäyiia Tö ÖTto'iov drroötiKVÜEi tö <k» 
a<pci\i(; Tfjq dpTTjpiaKfjq aliiooTaolaq. 

'E^EXäXEoa |iet' ^niTuxlaq KoXniKdq Kai 
KOiXiaKdq EyxEiptjotiq Etq Täq iiEyaXuT^pa«; 
riavEiticrXTjmaKdq KXiviKdq Tfjq EüpünTjq dvEii 
dnoXiv^oFcoq KaTd xdq KOiXiaKdq öcTEpEKTo- 
Hdq Töv jiTjTpialcov dcyyElcov, KaTd bt TdQ 
KoXniKdq ^yxEipfjoEiq dtVEu denoXivüoEtjq oübE- 
vöq dyyEiou. Iva dnobEl^cj Tfjv ^v^pyEiorv toü 
Tannöv. np^itEi ö^coq vd tovIocjuev ^VTaü9a 
ÖTl Tö Tannöv Ö^ov vä xP1<''t'0''^oin'^0'i jiövov 
Elq nEpiTtTiijoEiq dvdyKrjq. ^nl al^oppaylaq 
fjTiq Korx' dXXov xpötiov oOööXtoq f\ büay(^tp(ji<^ 
inloxETai, önöTc toGto nap^x^i ßE&alav ßo« 
fjÖEiav. 

"ETäpa nEplnTcootq ^ijKiPuoytiq Tou Ta^inöv 
Elvai i\ äirioxeoiq xfjq aiiioppaylaq ^lETd Töv 
ToKETöv, EVEKa dcTovlaq Tfjq ^ifjTpaq nETd Tfjv 
^KSoXfjv ToG TtXaKoövToq. itpäyua tö öiroiov 
dGECopEiTo ^EXPi to05e ^v iK TCOV dXüTOJV npo- 
•XTindTuv Tijq /vkxuuTiKijq. 

*H tijKxpjioyfj TOU TajiTtöv Elq Tdq ToiaüTa«; 
nEpimoHJEiq ^KXEA.Eixai Kaxd xöv fe^ijq xpö- 
nov: 'H do9Evfjq xoTiv.6EXEixai tni xijq nXa- 
ylaq nXEupdq Tijq KXivrjq oüTcoq, 6ote Td l- 
axlot vd npo^xo"^. Tä d^uTEpiKd yE\'VTjTiKdc 
öpyava Ka9api^ovTai, ö KoXEöq dnooTEipoü- 
Tai Kai fj oOpoböxoq KÜoTiq KEvouTai 8id Ka- 
9ETfipoq. Mexö Tfjv TcmoÖETTjaiv Eüptcov 5ia- 
oToXäojv ^v TU) KöXno) ouXXanSdvojiEv 5i* dy- 
KioTpoEiÖüv XaSlbojv TÖ TipöoGiov Kai tö önl- 
o9iov x^i^o^ "^oö auxevoq Kai ^Xkojiev TaüTa 
loxupwq Tipöq xd Kdxo) Elxa ElodyouEV Toüq 
KoXnobiaoToXEiq ivröq Tijq KOiXöTTjxoq Tijq 
jirjTpaq oüTcjq, üote Tö otö^iov aüTfjq vd Öl« 




'\oxvpct 2X^1 q ToG TopiTOv npoq xd kÄ- 
TM Kai dcpaipEoiq toü nXaKoOvToq. 

aoTaXfj Eup^toq, "Ev ouvEXElg TipofialvouEV 
Elq Tfjv ä«|Kxpiioyf|v tou Tannöv, ü>q tö toi- 
outov npäTToiiEv Kaxd Tdq KoXniKdq öoTspEK« 
Tojidq iv nEpiTtTtöoEi aljioppaylaq. Eladyo|iEV 

ItpcÖTOV TÖV KEVÖV odKKOV Elq TtjV KOlXÖTTjTa 

xfjq nnxpaq bid oxeiXeou V\ ^laKpäq dvocTO|ii» 
Kijq XaSlboq Kai dKoXoüGtoq nXTjpounEV TöV 
odKKOV öid jiaKpäq Xcopiboq yd^tj«;' '£•' ^'^' 



(3) N. Christopoulos : Anatomische Er- 
gebnisse der Blutstillunqsmethode nach 
Loqothetopoulos. Zbl. Gynaekologie. 1933, 
iNo. 14. 

699 



r 



1 



METPHTHZ 
TON ANEZEON MAI 

'H v^a ivTUTrcjaiaKr) dpEpiKaviKri l^to- 
pcoic; tfi/ai ^iia auoKtur] 5id Tf|c; ötroi- 
aq KaTapcTpÖTai 6 6a6^6q tuv dveaeuv 
eiq TÜq ÖTToiaq ^H tvaq ävöpWTroq. 

'H auoKiur], öttcj^ TrepiypOK^eTai dtc- 
Xw(; eiq £va ttepioöiköv xfiq Ncaq 'Yöp- 
Kriq, cTvai ^iriPTMCvri eiq 6Ep^iö^ieTpov Kai 
L/ypöncTpow Kai ÖTov ol ÖciKTai dp^oTt- 
pcov auiXTxipouv tiq t6 T5iov anMCiov, tö- 
te f\ dtveaic; etvai -rrXripnq. Ol 6t?KTai toü 
6epjiO|ieTpou Kai üypoiJEtpou Kivoüvrai ^- 
"iri Midq -rrXaKÖq pe ^covaq xPWMCXTiaTdq 
— dpuöpdv, Kuavfjv, TTpaalvr|v Kai KiTpi- 

vnv. 



'H dpxn ToO iQi[iou ÖTTcoq at Iva irr\- 
(JT][iov yeüpa ÖiirAa diTO Iva Kupiov irpt- 
TTEi vd KdÖETai KOI pia Kupla, 9d irpt- 
TTCi vd dva^rjTnön tiq tov l4ov aiwva, 
ÖTTOTc ol 5üo au^uyoi ^Tpcoyav dirö tö 

VßlOV TTldTO Kai ixpr]Oi\iOT[0\QUV TÖ Tl6l- 

ov TTOTrjpi 6id vd ttivouv. 



MIA ZXE^ON RANAKEIA 

TO XAQPIOYXON MArNH2:iON 

*H dirXoüaTdTn XPHorx; toü. 



paXXfjXou 6£ov vot npoo^x^k^^v» 'f^« ^ Xcjpiq 
KOTavE^tTai laontpcdc; -npöc; öXaq xdq 6ieu- 
ölvoek; ivTöq ttjc; unTpiKiriq koiXött|To<;, Iva 
6 nXiiptoetlc; oükkoc; TtpoaXd^o "^^ '^XTW^^ V^^' 
KUToq Kai KaTd xfiv gX^iv iif] ^^^XBxi npöq Tdc 
t^cj. ElTa öianEpünEV rd öcxpa tüv yaC,uiV 
6id ^Eoou 5aKTDX(OEi6o0q iteoooO, töv önolov 
«üöoüuev 6id TTjq dpioTtpäq X^ip6<; ^'"^ "^oö 
alöoiou, ivü f| 5E^i(k x*^^P 2Xkei loxupciiq Tdt 
öKpo Ttiiv ya^wv. 'AKoXoOScoq 6 ßoiieoq toito- 
ÖETfi laxupdcv Xa&L5a dKpiScöq npö toü nto- 
ooo, ÖOTiq f\br] EOpioKETai jitto^u al5oiou xai 
XaCiSoq. 'H aluoppayia H£Td ifjv TonoetTT]- 
Oiv TOü Tatinöv äixiaxtTai ndpauTa. 

*0 KaöriYTiTfiq TTiq A' MaituTiKfiq Kai fu- 
\aiKoXoyiKifjq KXiviKiiq toO navEiiiaTimlou Ti^q 
Bi^WTiq TqssIIo Antoine, elq tö Biologie 
und Pathologie des Weibes (4) öiartpayiia- 
Tku6|i£Voq Tö Qi^ia töjv pfj^Euv Tf\q lifjTpaq 
(Tötioq IX, atXlq 389—623) ypd«|>ci Td i^r^q 
oxETiKÖJq \ii TT^v ÖEpaiTElcrv TÖV Capeiuv ne- 
piTnwotcov pfi^Ewq Triq jifiTpaq, KaO' dq nepi- 
riwoEiq f| äyxElpiioiq biv Elvai SuvaTöv vd 
tEXtoBfi d^^otuq Ttpöq änlaxEoiv Trjq tocjTtpi- 
Kiriq al^oppayiaq: «"Höri itiaTEüu ÖTi ty[^o\it.v 
tv [iiaov, TÖ ÖTTolov Elq ToiaüTaq ßapEiaq dc- 
iXEX-rtioTiKdq KaTaoTdoEiq, KaöioTö BuvaTf)v 
Tfjv ^ETa(|>opdv TT^q doBEVoOq Elq Noookohei- 
ov npöq iyxElPTioiv. Tö \iiaov toöto Elvai tö 
TanTTÖv KOTdc AoyoÖETÖTtouXov. Nojll^CJ, ÖTl Tö 
TaniTÖv ^flioriq Kai Etq TtEpiTtTwoEiq pri^Eiov 
Tf)q ^f]Tpaq öüvaTai vd npootpipw ä^aipETiKdq 
CmnpEolaq Tö Tannöv biov vd ^<|Kxp^ö^TiTai 
diJ^ocjq, wq Kai Elq Tdq KoXniKdq iyxfipf]0Eiq 
f| iv&o^TiTpiKCüq (Eiq x<*Xapdv iif|Tpav) V\ öid 
\iiaou TOÜ prjynaToq Elq Tf)v nEpiTovaiKf|v 
KOiXÖTTiTo. Aid Tliq iipapnoynq ToO Tannöv 
iTiloxETai f\ al^oppayla KEpauvoSÖXuq, itpä- 
•y^a Tö öitoiov 6i" oüÖEVöq dA.Xou ouvTripriTi- 
KoG UEODU Etvai KaTopecjTöv. ndq öoTiq dita^ 
tüptQr\ tlq ToiaüTTiv S^oiv, 50voTai vd Cmo- 
Xoyla]], Tl aimalVEi toüto 6id töv x^>^Po^P* 
•yöv». 

Utpaiitpoi ö Antoine WEpiypdi^ci XtnTo- 
^cpüq Ttiv £(^apnoyfiv toG Ta^nov Trapaö^Tuv 
Kai ElKövaq Ik toü ßi«A.ioo (iou «Gynaekolo- 
C sehe Chirurgie». Iuviotcjuev öeev. Iva Td 
oid tt)v ä4>ap(ioytiv TOÜ Tairnöv xP^^üÖt) El- 
vai Elq ■nütvTaq Toüq toKETouq Ik tcov npoTt- 
puiv {Toiiia Kai dTitaTEiptj^^va tvTÖq iiETaA.- 
Xivou 6oxEiou. 'H iv^pytia Elvai Töaov dnE- 
ooq Kai do^Xfiq. Xöyu) Tfjq \ii\ Eloxojp^iaEcjq 
nX^ov aijiotToq ävTöq Ttiq nfjTpaq. «q Ik Ti^q 
oujimtoECjq tojv ^r^Tpialcov dyytlcjv üixö toij 
Ta^iTiöv ^m TiiJv ToixtoiidTujv Ti^q Ttu^Xou, üote 
ndq äuEpxö^Evoq ÖdvaToq iE, al|ioppaylaq, l- 
VEKa dTovlaq Ti^q jif)Tpaq, 5^ov vd 8EtjpfiTai 
(bq douyxwpiTov 0<|>dXiia toü laTpoö. 

EIZ TO EnOMENON: Tö T^Xoq 



(4) Seitz ■ Amreich : Biologie und Pa- 
thologie des Weibes. Bond IX, Geburts- 
hifte (3), von Prof. Tassilo Antoine : Ute- 
rusruptur, 1950. Urban und Schwarzen- 
berq. 

700 



npeTTEi KOcvEiq vd ^TTavaXajjßävi;! auxva 
TÖq M^yti^a«; dXT^eEiaq, ötov ö KÖopoq 6ev 
TÖq rrpooExti öaov dpKEi. Kai ttpettei vd 
öpoXoynawviEv öti etteito dTTÖ töv öopu- 
6ov TTou EyivEv dXIyov rrpö foO TroXE^ou 
IjETd Tdq dvaKOivwCTEiq tou fdXXou Kaör^- 
yriToG NTEXfiTTE 5id Td ahia Triq kotq- 
TrXriKTiKfiq 6ia5öa£uq toG KapKivou KaTÖ 
Td teXeutoTc ETri, öXoq ö KÖa^oq ^Xnanö- 
vnoE Tdq au^Coi^Xdq tou. 

Tpcbyo^Ev KQTd Td TEXeurala eth dXd- 
ti « pacpivapiGMEvo >, 5r|Xa6n TeXEicoq d- 
TTriXXaypEvov öttö tö x^t-^ptoOxov ^ayvn- 

(TIOV, TÖ OTTOuSaiOTaTOV aLKTTOTIKÖV TOü, 

TpcbyouEv Td ßpaapEva XaxaviKd teXeicoc; 
OTEyvd, ivd Td Kupia auoTaTiKd tou, tq 
äXoTa Kai metQ^G aÜTcov toc toü ^ayvQ- 
oiou, (pEuyouv [xi tö vEpö tou ßpao■^lOu, 
xprici MOTTO ioümev Xoycp thc dvayKaaTiKnq 
EVTaQEcoq Tcöv KaXXiEpyEiuv, yEwpyiKd 
TTpoiövTa EaTEpHMEva tcov dXoTcov toü pa- 
yvnoiou Kai tüv dXXcov petoXXwv. Elvai 
6e töc dXaTa aürd dirapaiTriTa ox' pövov 
5id thv irpöXriipiv toü KapKivou, dXXd^ yE- 
viKcbq 5id thv EÜpu6pov, KovoviKnv Kai Ka- 
Xnv XeiTOupyiav toü öpyavianoü. 

*H diTouaia tou payvriaiou Kupicoq dirö 
Tf|v öiaTpocpnv paq, eTvqi d^opun irXEtaTcov 
öpyaviKcov öioaapaxwv. 'O NteXptte tö e- 
XEi dTToSEi^Ei [xi TrXEToTa TTEipaMaTd tou. 
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Statt dieser Originalmethode ist die Modifikation nach Kielland 
vorzuziehen. Durch diese Operation wird der zwischen Corpus und Cervix 
uteri vorhandene Winkel aufgehoben und die Cervix dadurch auf die hin-- 
tere Vaginalaxe verlagert. 

Die Vagini fixation nach Sohauta-^Wertheim mit oder ohne Modifizier 
rung nach Kielland habe ich in der lezten Zeit wegen der relativlt^großen 
Mortalität und wegen der nicht seltenen Rezidiven verlassen. Ebenso wäHde 
ich aus dem gleichen Grunde nicht mehr die vaginale Total ext irpation an, 
die ebenso gute statt sMsohe Resultate gibt, aber doch einen größeren Ein-- 
griff darstellt, sondern begnüge mich mit der Abtragung des ganzen unteren 
Teiles des Uterus im Zusammenhang mit der Bildung einer engeren Vagina und 
eines starken Perineums. Die Operation ist leicht auszuführen und hat mir 
bis Jetzt die besten Resultate gegeben. Si€ ist im Prinzip der hohen Portio 
amputatiom ähnlich, mit dem Unterschied, daß der Uterus viel weiter oben bis 
zum Fundus abgetragen wird,wofür ich vorschlage fJf^ÄJwfaie Uterusam^utation. 

Die Operation wird auf folgende Weise ausgeführt: Die Portio wird 
mit Kugelzangen gefaßt und stark nach abwärts gezogen. Nun wird die Scheide^ 
wand in ihrer ganzen Dicke mit einer kräftigen gebogenen Schere l/2cm. ober- 
halb des Überga7iges der Scheiden in die Portioschleimhaut zirkulär umschni- 
tten und teils stumpf , teils mit der Schere etwas nach oben präpariA. Die 
Blasenwand wird Jetzt nach oben zu abgespannt und mit$ /kleinen Schnitten di$^ 
nun deutlich sichtbar werdenden vesicocervihalen Bindegliedstränge getrennt 
und dadurch die Blase von ihren festeren Verbindungen mit der Cervix loage-- 
löst. Die Blase wird dann mit dem Finger nach oben geschoben. Nachdem auch 
die seitlichen Blasenpartien nach oben und nach derSeiiif geschoben worden 
sind, legen wir das vordere Vaginalspäkulum unter die Blase und iringen sie 
und die Wticä^äA Ureteren auf diese Weise außerhalb des Operationsgebietes. 
Das nun deutlich sichtbare Peritoneum^ wird mit einer Pinzette gefaßt und 
mit einem Scherenschlag geöffnet und die Öffnung nach beiden Seiten erweiJ* 
tert(Abb.71,75,76,77). Das so ^0öffnet^ Peritoneum zieht sich von selbst o- 
der mit Nachhilfe des Fingers durch das Abwärtsziehen des Uterus zurück und 
wird mit einigen Nähten auf die vordere Uteruswand 0^^ 3V2-3 cm. unterhalb 
der Fundusoberfläche befestigt. Die Scheide wird dann auf beiden Seiten 
hochgeschoben, nachdem die Uteringefäße mit Klemmen gefaßt und unterbunden 
worden sind. Die Portio wird stark nach vorne gezogen, das Douglas Perito- 
neum geöffnet, nach oben geschoben und auf die hintere Uteruswand und in deX 
gleichen Höhe mit dem Blasenperitoneum mit einigen Nähten befestigt. Der 
nun freiliegende Uterus wird direkt unterhalb der Peritoneal nähte mit dem 

Messer oder mit der Schere abgetragen. Die Uteruswunde wird nach der Metho- 
de von StuiOndorf mit der ^aginalwandung bedeckt. 

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Bei kleinen atrophischen Uteri verzichte ich auf die Eröffnung des Pfrito-- 
neums, dasselbe wird möglichst hoch geschoben und der Uterus direkt unterhalb 
der Insertionsätelle des Peritoneums abgetragen. Anschließend wird die vordere 
und hintere Vaginalplastik und dte Bildung eines festen Beckenbodens vorgenom- 
Tfienm 

Die Resultate der Operation sind so günstig, daß dieser Eingriff in meiner 
Klinik bei großen Uterusprolapsen die Operation der Wahl darstellt. Ich habe 
bis Jetzt bei 81 Fällen die Sich selbst operiett habe nur ein Rezidiv des 
Scheidenvorfalles beobachtet, so daß eine Wiederholung der plastischen Opera-- 
tion der Scheide notwendig wurde. Die B*» Todesfälle die vomommen sind/nicht 
auf die Art der Operation zurückzufuhren, da die eine an Embolie und die. zwei- 
te an septischer Urämie ^AfNt starb. Es handelte sich bei beiden um sehr herun- 
tergekommene Patient inen. 

Der Vorteil der Operation ist, daß die Ausführung leicht ist und die Gefahr 
äußert gering, da man S4Ää* der Peritonealhöhle gar nicht in Berührung kommt. 

Bei jungen Frauen beste^fein i;eiterer Vorteil daß die Menstruation erhalten 
bleibt. 



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Obwohl die erste Auflage von längerer Zeit vergriffen war, ist es 
nicht möglich gewesen die zweite erscheinen zu lassen. 

Bei der zweiten Auflage sind zwei neue Methoden hinzugefügt worden. 
Die erste betrifft die Geburtshilfe; es handelt sich um die Therapie der 
atonischen Blutungen nach der Geburt der Plazenta. 

Die zweite ist die subfundale Uterusamputation bei Prolapsen und bei Me- 
trorrhagien. 

Da ich durch diese Methode bessere Reim^ltate erreicht habe, werde 
ich nicht mehr die sagitale ITterusamputati on beschreiben. 



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Zentralblatt für Gynäkologie 

Gegründet von H. FRITSCH. Herausgegeben von Geh. Med.- Rat Prof. Dr. 
^V. STOECKEL, Berlin. Jährlich 52 Hefte. 1940 im 64. Jahrgang, gr.8». 

Viertel) ährlidi RM. 14.60 

Als einzige Wochenschrift In der deutschen Frauenheilkunde und Oeburtsiillfe ist das Zentralblatt eine Zeitschrift de» 
praktischen Frauenarztes. Die 62 abjreschlossenc n Jahrgänge sind in der ganr '»-ont die Annalen einer entscheidenden 
Entwicklung, anderste, gebend oder nehmend, immer aber tätigen Anteil hatt» So wie sie mit ihren Beiträgen auf manch 
einem Gebiet dem Stand der Zei-* wegweisend vorauseilte, hatte sie auch 1 funktionellen Denken, seinen Anbruch früh 
erkennend, die Bahn In die Frauenheilkunde geebnet. Neue,vorwärtS8türmeiide Fragengruppen, Hormonforschung, Diätetik, 
Erbbiologie, Bäder- und Kümakundf, wurde offenen Blicks und frei von theoretischer Spekulation untersucht, wie es über- 
haupt das Kennzeichen des Zentralblattes ist, frühzeitig aus dem erst Werdenden, noch Fließenden das für den Praktiker 
Verwendbare sorgsam herauszuarbeiten. Besonders anreg-jnde und lehrreiche Fälle werden kasuistisch erfaßt und für weitere 
Verwertung der Erfahrungen festgehalten. Dem berechti-^ten Streben des Frauenarztes nach einer Weitung des Blicks über 
das engere Fachgebiet hinaus dienen Beiträge aus Nachbarfächern. Laufend erscheinen Sitzungsberichte der verschiedenen 
Gesellschaften; und Einzelreferate, auf die der umsieht ge Arzt weder verzichten kann noch will, unterrichten über die 

Arbeit anderer Fachotgane in zeitsparender Form. 

Gynäkologisdie Operationen 

Von Prof. Dr. F. von MIKULICZ-RADECKI, Direktor der Univ.-Frauen- 

klinik, Königsberg i. Pr. VI, 132 Seiten mit 146 meist farbigen Abbildungen. 

1933. 4*. Geb. RM. 19.50 

(Erweiterter Sonderdruik aus Bier- Braun- Kümmelt, Chirurgische Operationslehre, 6. Aufl., 
Band IV, herausgegeben von F. Sauerbruch und V.Schmieden) 

Zeitschrift für Geburtshilfe: In diesem Werk erfährt die Operationstechnik der Stoeckel sehen Schule eine ganz hervorragende 
Darstellung. Die vaginalen Methode\i, die an dieser Klinik in besonderem Maße gepflegt werden, sind in Wort und Bild 
so klar und verständlich geschildert, daß auch der vaginal nicht sehr geübte Gynäkologe sicher großen Nutzen aus dem 
Studium dieser Operationslehre ziehen wird. Es besteht für den operierenden Arzt die Gefahr, in seiner Methodik zu er- 
starren und Ich halte das Buch des Verfassers gerade darum für so wertvoll, weil es den Operateuren anderer Schulen die 

eigene Technik so klar und bis in alle Einzelheiten darstellt. 

Die Praxis dt^r Ster ilisierungsoperationen 

Von Prof. Dr. K. H. BAUER, Direktor der Chir. Univ.- Klinik, Breslau, und 

Prof. Dr. F. von MIKULICZ-RADLCKI, Direktor der Univ.-Frauenklinik, 

Königsberg i. Pr. VI, 1 76 Seiten mit Ql Abbildungen. I936. gr.8°. 

RM. 15.40, geb. RM. 17.— 

Berichte Ober die gesamte Gynäkologie: Die Verfasser geben Jedem Operateur, der sich mit den Problemen der Sterilisierung 
zu befassen hat, wertvolle Hinweise in die Hand. Ganz besonders sind die Indikationsstellung zur Sterilisierunf sowie 
alle sich an diese anknüpfenden Fragen sowohl Juristischer als auch medizinischer Natur und die bisher auf diesem un- 
geheuerwichtigen Gebiet gesammelten Erfahrungen herausf^estellt. Welt über den Rahmen eines Nachschlagewerkes hinaus 
gibt es Jedem den Anreiz, etwa bestehende Unklarheiten zu beseitigen. Die Vor- und Nachteile aller bisherigen Sterilisierungs- 
methoden sind kritisch behandelt. Ein anschauliches Bildmaterial begleitet den Text ; alles in allem, endlich das Standardwerk. 

"' Schmidt v. Elmendorf 

Deutsches Gynäkologen-Verzeidmis 

Wissensdiaftlidier Werdegang und wissensdiaftlidies Sdiaffen deutsdier 
Gynäkologen. Herausgegeben von Geh. Med.- Rat Prof. Dr. W. STOECKEL, 
Berlin. Bearbeitet von Dr. F. M1CHEI.SSON, Sdiömberg im Sdiwarzwald. 

2. Auflage. XII, 581 Seiten. 1939- gr.8«. 
Geb. RM. 28.—. Für Mitgl. d. Deutsdien Gesellsdi. f. Gynäkologie RM. 24.80 

Das „Deutsche Oynäkologen-Ver: elchnis" bietet die genauen Anschriften der arischen, deutschsprachigen Gynäkologen des 
In- und Auslandes. Doch ist dieses Werk mehr als nur ein zuverlässiges „Adreßbuch", es enthält weiter den beruflichen 
Werdegang dieser Gynäkologen und ihre wissenschaftlichen Arbeiten in Büchern und Zeitschriften. Die Gynäkologen der 
Ostmark und des Sudetengaues vurden g-eichfalis mit aut'genommen. Die Aufgliederung des reichhaltigen ^toff es nach 



verschiedenen sachlichen Gesichtspunkten gewährleistet, alle gewünschten Auskünfte rasch zu find 
Ein ausführliches Probeheft sende ich Ihnen gern kostenfrei 



iTn. 



JOHANN AMBRO SIUS BARTH / VERLAG / LEIPZIG 



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VORWORT J^,H Oi-Utti Ä^uL._L^^: 



Die Herausgabe einer neuen in deutscher Sprache geschriebenen gynäkologischen 
Operationslehre hieße ,, Eulen nach Athen tragen", da ja schon eine große Anzahl 
schöner, allen Anforderungen Rechnung tragender deutscher Werke vorhanden ist. 
Aber jeder Chirurg weiß, wie lehrreich und vorteilhaft es ist, andere erfahrene Of)era- 
teure bei ihrer Arbeit zu beobachten, um dadurch sein eigenes Können, besonders hin- 
sichtlich der Technik, zu erweitern. Ein solches direktes Beobachten wird nun oft aus 
äußeren Gründen nicht möglich sein, und man muß zu Ersatzmitteln greifen, zu Be- 
schreibungen und Abbildungen, wie wir sie in den bekannten Operationslehren und in 
den Fachzeitschriften finden. Mancher Operateur hält die Veröffentlichung von tech- 
nischen Kleinigkeiten für überflüssig, obwohl gerade durch solche Angaben die Aus- 
führung der bekannten typischen 0})erationen erleichtert wird. In diesem Buch will 
ich die in meiner Klinik in Gebrauch befindlichen und bewährten Oi)erationen, sowohl 
typischer Art wie auch von mir angegebene Modifikationen und eigene Methoden aus- 
führlich beschreiben. Ich gehe jedoch auf Operationen, die in allen Kliniken in gleicher 
Art und Weise, sowie auf solche, die in unserer Klinik selten ausgeführt werden, wie 
z. B. die erweiterte abdominale Uterusexstirpation, nicht näher ein, da sie ja in allen 
Operationslehren ins einzelne gehend abgehandelt sind. 

Besonderen Wert habe ich auf die genaue Schilderung der vaginalen Operationen 
gelegt, die meines Erachtens heute nicht mehr gebührende Berücksichtigung bei der 
Ausbildung junger Gynäkologen finden, obwohl nur der Gynäkologe, der die vaginale 
Technik voll und ganz beherrscht, die richtige Indikation stellen kann, ob vaginal oder 
abdominal vorgegangen werden soll, und alle Vorteile des vaginalen Weges gebührend 
zu schätzen weiß. Es dürfte nicht vorkommen, daß die einzige Indikation zum abdomi- 
nalen Vorgehen die mangelnde Erfahrung und ungenügende Technik im vaginalen 
Operieren ist. Man darf auch nicht vergessen, daß dem im vaginalen Operieren Geübten 
seine subtilere Technik beim abdominalen Vorgehen sehr zustatten kommt. 

Ich habe ferner vermieden, auf Indikationsstellung einzelner Operationen näher 
einzugehen, da das dem Zweck dieses Buches nicht entsprechen würde und da in fast 
allen Lehrbüchern genügend genaue Erörterungen vorhanden sind. Aus dem gleichen 
Grunde vermeide ich Beschreibung der Operations Vorbereitung, der Asepsis, sowie der 
Nachbehandlung und der Narkose. 

Den größten Wert legte ich auf die sorgfältige Ausführung der Abbildungen, die 
unter Zuhilfenahme von während der Operation angefertigter Skizzen und Photo- 
graphien von Frau Margarete We n d 1 a n d unter meiner Kontrolle gezeichnet wurden. 
Für ihre unermüdliche, gewissenhafte Arbeit spreche ich der Künstlerin, die sich 
mehrere Monate in Athen aufhalten mußte, auch an dieser Stelle meinen Dank aus. 



Athen, August 1939 



K. LOGOTHETOPÜLOS 



\'\ 



< 



INHALT 



4 



' 



Allgemeiner Teil Seite 

1. Mittel zur Blutstillung 1 

2. Blutstillungsmethode für Notfälle nach Logothetopulos 5 

3. Laparatomie ^^ 

a) Lagerung der Patientin ^ 1 

b) Der Medianschnitt ^^ 

c) Suprasymphysärer Querschnitt nach Pfannenstiel 15 

d ) Bauchdeckennaht ^ ^ 

e) Erleichterung der Appendektomie beiLängs- und Querschnitt nach Logothetopulos 16 

f) Freilegung des Operationsgebietes durch Abstopfen der Darmschlingen 17 

g) Peritonisierung und Drainage der Bauchhöhle 19 

4. Vaginale Operationen 1^ 

a) Colpocoeliotomia anterior 23 

b) Colpocoeliotomia posterior "3 

Spezieller Teil 

I. Chirurgische Behandlung der Lageanomalien des Uterus 24 

A. Retroversioflexio uteri 24 

1. Fixation der Lig. rotunda 24 

a) Operation nach Alexander- Adams 24 

b) Operation nach Olshausen 24 

c) Operation nach Doleris 25 

d) Operation nach Webster-Baldy 25 

2. Abdominale Vesikof ixation 25 

3. Verkürzung der Ligamenta rotunda mit gleichzeitiger Vesicof ixatio 
uteri nach Logothetopulos 26 

4. Direkte Befestigung des Uterus an den Bauchdecken 27 

B. Descensus und Prolapsus vaginae 27 

1. Vordere Kolporraphie 27 

2. Hintere Kolporraphie und Perineoplastik 29 

3. Operation des veralteten kompletten Dammrisses 32 

C. Descensus und Prolapsus uteri 35 

L Interpositio uteri vesicovaginalis 35 

II. Operationen an der Vulva ^^ 

1. Exstirpation der Bartholinischen Drüse 36 

38 

2. Carcinoma vulvae 

III. Vaginale Operationen am Uterus 

1. Ausschabung des Uterus 

Komplikationen bei der Ausschabung *^ 

2. Operation alter Zervixrisse. a) nach Roser-Emmet. b) nach Sturmdorff 45 

3. Diszision der Cervix nach Pozzi ^^ 

4 yinitiflll ii ii t iiii ^ < il ' » Ui i'iiiiii i v j-tinn vor d b r #« i i c i 4€ r a.u s 46 



VI Inlmlt 

Seite 

5. D io vaginalo Totaloxst iri)ation dos UtoruH ^^ 

a) Vaginale Totalcxstirpation mit Spaltung der vorderen Uteruswand 55 

b) Vaginale Totalexstirpation des Uterus mit Spaltung dvr vorderen und hinteren 
Uteruswand 5o 

6. Vaginale Operationen bei Uterus myomatosus 56 

a) Gestielte submuköse Myom(> (Polypen) ^" 

b) Vaginale Enukleation von Myomknoten 56 

c ) Vaginale Utorusexstiri)ation bei Uterus myomatosus 56 

7. Erweiterte vaginale Operation des Carcinoma colli uteri 60 

8. Abdominale Operationen am Uterus ^^ 

a) Das gestielte subseröse Myom ^3 

b) Die Enukleation der Myome ^'^ 

c ) Die abdominale sagittale Uterusresektion ^'^ 

d) Die supravaginale Uterusexstirpation 6ö 

e) Die abdominale Totalexstirpation des Uterus 71 

9. Die Ovariektomie 74 

a) Die abdominale Ovariektomie 74 

b) Die vaginale Ovariektomie 78 

10. Entzündliche Adnexerkrankungen 79 

a) Abdominale Operation der entzimdlichen Adnexerkrankungen 80 

b) Vaginale Operation der entzimdliehen Adnexerkrankungen 83 

11. Craviditas extrauterina 86 

12. Die chirurgische Behandlung der Parametritis 88 

Die Behandlung der chronischen Parametritis durch künstliche Abszeßbildung nach 

Logothetopulos 89 

13. Die zirkumskripte Stenose der Scheide 93 

14. Die totale Atresie der Scheide — 93 

Häniatokolj)os und Hämatometra 93 

15. Die Bildung einer künstlichen Scheide 93 

16. Die Blasenscheidenf istel 94 

Blasenscheidenfistel mit Zerstörung des Sphincter vesicae und der Harnröhre 100 

17. Die Rektovaginalfistel 103 

Sachverzeichnis 105 



ALLGEMEINER TEIL 



Vor Ausführung einer jeden Ojieration hat der Operateur genau abzuwägen, ob 
die Größe und die Gefälirlichkeit eines Eingriffes dem beabsichtigten Zweck entspricht 
und vor allen Dingen der Patientin Nutzen bringen wird. 

Vorbedingung für einen günstigen Verlauf einer jeden Oi)eration ist die genaue 
Befolgung aller Regeln der Asepsis. Um aber ein gutes Resultat zu erhalten, um nach 
Möglichkeit alle Gefahren auszuschalten, muß der operierende Arzt operative Begabung, 
also Gewandtheit und Technik besitzen. Diese Eigenschaften sind unerläßlich, um eine 
genügende Schnelligkeit beim Operieren zu erreichen, denn je kürzer die Operations- 
dauer, um so besser sind die Resultate infolge geringerer Narkosedauer, kleineren 
Operationschocks und, wie experimentell nachgewiesen ist, geringere Verunreinigung 
des Operationsfeldes mit Mikroben. Es bedarf nicht der Erwähnung, daß die Schnellig- 
keit nicht auf Kosten der Blutstillung und der Asepsis erzielt werden darf. Unter 
.,asei)tisch operieren'' versteht man natürlich nicht nur Verwendung sterilisierter In- 
strumente, Tücher, Handschuhe usw., sondern hauptsächlich das Vermeiden der Über- 
tragung von infektiösen Keimen durch sinnlose und unvorsichtige Mani[)ulationen von 
infizierten Gebieten auf keimfreie während der Operation, wie z. B. bei der Eröffnung 
der Scheide, des keimhaltigen Uterus oder eitriger Adnextumoren. 

Das wirklich schnelle Operieren wird nicht durch bloße Fingerfertigkeit erreicht, 
sondern vor allen Dingen durch systematische, zweckentsprechende Bewegungen unter 
Vermeidung unnützer Wiederholungen, was nur bei genauer Kenntnis der Operations- 
anatomie und persönlicher Erfahrung möglich ist, 

1. Mittel zur Blutstillung 

Immer muß der größte Wert auf genaueste Blutstillung bei der Operation gelegt 
werden. Große Blutverluste schädigen den Gesamtorganismus und schränken seine 
Abwehrkräfte gegen Infektion ein. Blutansammlungen in der Bauchhöhle können zur 
Vereiterung führen, Hämatome der Bauebdecken verhindern oft die prima intentio 
der Operationswunden. Kapillare Blutungen stehen meist von selbst und bedürfen 
keiner besonderen Beachtung, solche stärkeren Grades werden durch leichten Druck 
mit einer Gazekompresse zum Stehen gebracht. Kleinere Gefäße können mit einer 
Klemme gefaßt werden, die nach einiger Zeit ohne Unterbindung wieder entfernt 
werden kann. Man verwende immer das dünnste, eben noch ausreichende Katgut 
zur Unterbindung, um die Resorption zu erleichtern. Bei den meisten gynäkologischen 
Operationen fassen wir mit größeren, starken Klemmen mehrere Gefäße zusammen 
mit dem sie umgebenden Bindegewebe (Abb. 1—4). Viele Chirurgen lehnen diese Art 
der Unterbindung ab, da sie der Meinung sind, daß dadurch Gewebsnekrosen entstehen, 
die Infektionen begünstigen. Das ist jedoch nicht richtig, da einwandfrei erwiesen ist, 
daß trotz der starken Schnürung die Stümpfe noch genügend ernährt werden. Die 
Schürzung des ersten Knotens soll geschehen, während der Assistent die Klemme lang- 
sam und vorsichtig öffnet, wenn nötig mit beiden Händen, so daß der Faden langsam 
in die Klemmfurche hineinrutscht. Hierauf macht man den zweiten und bei Katgut 
auch noch einen dritten Knoten. Einen Fehler, den ich immer wieder bei jungen 



Allgcmoinor Teil 



1. Mittel zur Blutstillung 



8 



AsHistenten bemerke, möchte ich noch erwähnen. Sie stecken während der Unter- 
bindung die Finger in die Löcher der Klemme und erschweren dadurch dem Operateur 
die Arbeit, weil während der Ausführung der verschiedenen Unterbindungsmanöver 
die Klemme nach allen Richtungen leicht beweghch sein muß; ist das nicht der Fall, 
SU ist besonders in der Tiefe die Unterbindung kaum möglich. Erst nn letzten 





Abb. 1. 




Abb. 2. 




Abb. 3. Abb. 4. 

Abb. 1 — 4. Anlegung von Massenligaturen 

Augenblick, wenn die Klemme geöffnet werden soll, führt man Daumen und 
Zeigefinger in die Ringe ein. Die Methode der Blutstillung nach Doyen und 
Tuffier, bei der mittels starker, kurzer Klemmen ein sehr starker Druck 2 Minuten 
lang auf die Gefäße ausgeübt wird, die dadurch ohne Unterbindung geschlossen werden 
sollen, ist wegen der Gefahr postoperativer Blutung wieder verlassen worden. Macht 
bei vaginalen Operationen die Unterbindung von Gefäßen in großer Tiefe Schwierig- 
keiten, so kann im Notfall die das Gefäß fassende Klemme für 2 — 3 Tage in der Wunde 
liegen bleiben. Im allgemeinen steht dann beim Abnehmen der Klemme aber die Blu- 
tung. Da das nicht immer der Fall ist, das Liegenbleiben der Klemme Schmerzen und 



I 




Abb. 5. Fübrungssonde nach Amann 



Unannehmlichkeiten sowie Nekrose der Stümpfe mit erschwerter Wundheilung ver- 
ursacht, so ist nach MögUchkeit stets die Unterbindung zu erstreben. J)iffuse Blutungen 
werden durch Umstechung zum Stehen gebracht, oder man tam])oniert die blutende 
Stelle mit Gaze, setzt die Oi)eration fort und entfernt den Tam[)on wieder am Schlüsse 
der Operation. Sollte es dann trotzdem noch weiter bluten, so können wir erneut tam- 
ponieren und den Gazestreifen zwecks Ableitung des Wundsekrets nach außen leiten. 
Das geschieht besonders einfach bei der Totalexstirpation des Uterus, bei der wir die 
tamponierende Gaze mittels der Amannschen Führungssonde (Abb. 5) durch das 
Scheidenloch nach außen führen. Bleibt der Uterus erhalten oder amputieren wir 
supravaginal, so wird 
der Streifen durch 
ein zu diesem Zweck 
angelegtes Loch im 
hinteren Scheidenge- 
wölbe nach außen ge- 
leitet und dann die 
Bauchhöhle geschlos- 
sen. Zuweilen gelingt 
aber die Blutstillung 
mit einfacher Tam- 
ponade nicht, sei es, 
daß die blutende 
Fläche zu groß ist 
oder daß eine erhöhte 
Blutungsbereitschaft 
des Körpers besteht. 

In solchen Fällen, ebenso wenn Fassen und Unterbinden des Gefäßes mißlingt, 
wird die Tamponade nach Mikulicz empfohlen. Dieses Verfahren ist recht brauch- 
bar, jedoch muß man mit die Rekonvaleszenz verlängernden Sekundärinfektio- 
nen rechnen, und falls es sich um die Tamponade durch eine Bauchwunde handelt, 
ist die Gefahr eines postoperativen Narbenbruches sehr groß. Außerdem versagt die 
Methode bei starken arteriellen Blutungen häufig vollkommen. Von lokal zu ver- 
wendenden blutstillenden Mitteln machen wir keinen Gebrauch, ebenso verzichten wir 
auf den Thermokauter, weil der sich bildende Schorf leicht Anlaß zu Infektionen gibt 
und die Bildung von Adhäsionen begünstigt. Die Unterbindung der Arteriae hypo- 
gastricae zur Bekäm])fung abundanter Blutungen kommt für meine Klinik seit Ein- 
führung meiner Blutstillungsmethode nicht mehr in Frage. Sie wird noch von ver- 
schiedenen Operateuren prophylaktisch vor Ausführung der eigentlichen Operation 
zur Vermeidung starker Blutverluste ausgeführt, ist jedoch durchaus kein harmloser 
Eingriff, wie folgendes Vorkommnis zeigt. In meiner Klinik wurde von einem sehr 
bekannten ausländischen Gynäkologen eine abdominale Wertheimsche Operation 
lege artis ausgeführt, und zwar mit vorhergehender Unterbindung beider Art. hypo- 
gastricae. Die Bauchhöhle wurde offen gelassen und die große Wundhöhle mit Gaze 
austamponiert. 20 Tage nach der Operation bemerkte man Urinabgang aus der Scheide. 
Die Untersuchung zeigte eine Nekrose der Blasenwand, und das nekrotische Stück 
konnte von oben aus in toto entfernt werden. Nach 2 V2 Monaten wurde die enorme 
Blasenscheiden, jfistel" (Fehlen des ganzen Blasenfundus und der hinteren Blasen- 
wand!) unter Benutzung der vorderen Rektalwand als Ersatz für die fehlenden Blasen- 
teile von mir geschlossen. 



4 Allgemcinor Teil 

Um bei starken Blutungen das blutende Gefäß leichter auffinden zu können, 
drückt man mit dem Finger unter Zuhilfenahme einer Kompresse die Aorta fest gegen 
die Wirbelsäule, wodurch eine provisorische Blutstillung zustande kommt, die das 
Fassen der Gefäße ermöglicht. 




Abb. 6. Fixierung des vor der Vulva liegenden Wattebausches 
mittels eines um die Scliulter gelegten Verbandes 

Der Momburgsche Schlauch sowie die Vorrichtungen zur Aortenkompression 
von Riediger und Sehrt sind nicht ungefährlich und werden von uns nur im äußer- 
sten Notfall in der Geburtshilfe angewandt. 

Bei Blutungen, die zuweilen nach Operationen an der Vagina oder an den äußeren 
Genitalien auftreten und die meist auf Frühresor})tion von Katgutunterbindungen 
zurückzuführen sind, kann eine Scheidentamponade den ganzen Erfolg einer Operation, 
z. B. einer Plastik, in Frage stellen. Folgendes Verfahren hat mir stets gute Dienste 
geleistet: Ich befestige einen vor den äußeren Genitalien liegenden Wattebausch 
mit Hilfe einer Binde, die man zuerst zirkulär um die Hüften anlegt. Von hinten geht 
man dann zwischen den Schenkeln nach vorn und über die Schultern und wiederholt 



< 



2. Blutstillungsmethodo für Notfälle nach Logothetopulos 5 

diese Tour mehrmals, auf diese Weise einen starken Druck auf die äußeren Genitalien 
ausübend. Aus Abb. 6 ist dieser Verband leichter verständlich wie aus einer genauen 
Beschreibung. 

2. Blutstillungsmethode für Notfälle nach Logothetopulos 

[Von Nürnberger^) ,, Logotampon", von Sellheim^) ,, Griechenpilz" genannt.] 

Um die Tampondrainage von den Bauchdecken aus zu vermeiden und eine erfolg- 
reiche Tamponade durch die Scheide ausführen zu können, habe ich eine besondere 







' ^imy- ' -^::m5! i s Si, 



We^^Oaa/. 



Abb. 7. Blutstillungsmethode nach Logothetopulos. 
Einführung des Tampons in das Scheidenlumen nach der Exstirpation des Uterus 

Methode erdacht, die imstande ist, jede, auch die stärkste arterielle Blutung zu 
stillen. Sie ist nur für den Notfall gedacht und hat sich in zahlreichen Fällen seit vielen 
Jahren glänzend bewährt. Ich gehe in folgender Weise vor: 

Ich fülle einen aus einem quadratischen Gazestück bestehenden Beutel fest mit 
einem langen Gazestreifen aus, so daß ein etwa kindskopfgroßes, kugelförmiges Ge- 
bilde entsteht. Die Größe des Tampons hängt von der Lage des blutenden Gefäßes 
ab, sie muß um so größer sein, je weiter das Gefäß vom Beckenboden entfernt ist. 
Die vier Zipfel der äußeren, quadratischen Gaze sowie das heraushängende Ende des 



1) Zbl. Gynäk. 1926, Nr. 50, 3202. 



2) Zbl. Gynäk. 1930 Nr. 21, 1318. 



Allgcnnoinor T(m'1 




2. Blutstillungsmothode für Notfällo nach Logothotopulos 



7 



T ^ ----«■' 



Abb. 8. mnt »iill i i>grTrff i i ii ( i liuitf 

ScliematisclK^ Darstellung (l('s Vorganges in Abb. 7 



Abb. 0. 

l w^^<>i,Kn||npii \f\M Star- 
ker Zug nach abwärts bis 
zum Eintritt des Tampons 
ins kleine Becken 





^HHH 




Abb. 13. Blutstilluugs- 
methode nach Logothe- 
topulos bei v^aginalen 
Operationen. Ausstopfen 
des leer eingefü hrten Gaze - 
beuteis mit dem Streifen 



Abb. 14. Hhi t nti lli m j r nm r thnda i tirifrh 

K. Richtige Lage des 
Tampons. Schematische Darstellung 



/ 



10 



Allgomoinor T(mI 



fülle. Hierbei muß man darauf achten, daß der Streifen gleichmäßig nach allen Seiten 
in die Beckenhöhle verteilt wird, so daß der gefüllte Beutel die Form eines Pilzes 
annimmt (Abb. 14). 

Zur Vermeidung von Nekrosen, die durch zu starken Druck des Pessars auf die 
Vulva entstehen könnten, lege ich zwischen Pessar und Vulva auf beide Seiten des 
Tamponstieles einen kleinen Wattebausch. Aus dem gleichen Grunde wird die vor 
dem Pessar liegende Klemme nach 8 Stunden entfernt. Jede weitere Manipulation 
an der Gaze muß man aber vermeiden, weshalb man das Pessar am besten noch einen 
weiteren Tag liegen läßt. Am 3. Tag fängt man an, den inneren Streifen nach und nach 
herauszuziehen, und am 5. Tag entfernt man auch die äußere quadratische Umhüllungs- 
gaze des Tampons. 

Einerseits um zu bestimmen, wie der Tampon wirkt, andererseits um seine genaue 
Lage zu den Organen des Beckens festzustellen, wurden im hiesigen Anatomischen 
Institut von Christo pulos unter der Leitung von Sclavunos Untersuchungen an 
der Leiche angestellt i) . Es wurde einwandfrei festgestellt, daß Darm, Blase und 
Ureteren außerhalb des unter Druck gesetzten Gebietes liegen und jede Schädigung 
ausgeschlossen ist, was auch mit den klinischen Erfahrungen übereinstimmt.^) Ferner 
blieb die Umgebung der durchschnittenen und nicht unterbundenen Art. uterinae 
vollkommen frei von Farblösungen, die unter hohem Druck in die Karotiden ein- 
gespritzt wurden. Beweis für die Sicherheit der arteriellen Blutstillung. 

Auch bei postoi)erativen Blutungen war mir der Tampon zu wiederholten Malen 
von größtem Nutzen. In solchen Fällen ap{)liziere ich den Tampon nach Wieder- 
eröffnung der genähten Scheidenwände und des Peritoneums von der Scheide aus, 
gleichgültig, ob vaginal oder abdominal operiert worden war. Bekommt der Tampon 
die richtige Größe, d. h. füllt er das kleine Becken genügend aus, so steht die Blutung 
in allen Fällen prompt. 

Bei heruntergekommenen Patientinnen und komplizierten Bauchoperationen ver- 
zichte ich, besonders dann, wenn eine Scheidendrainage notwendig wird, auf die Unter- 
bindung der in der Tiefe liegenden, schwer erreichbaren Gefäße und lege den Tampon 
ein, worauf die angelegten Klenmien wieder entfernt werden, bevor der Tampon end- 
gültig in seiner Lage befestigt ist, in dem Augenblick also, in welchem der Assistent 
den Tampon nach unten zieht. Ich sehe nicht ein, warum das Leben der Patientin 
gefährdet werden soll, nur weil man die Blutstillung durch Unterbindung aller Gefäße 
oder die genaue Peritonisation erreichen will, wodurch die Dauer der Operation erheb- 
lich verlängert wird. Wer einmal die Anwendung des Tampons erlernt hat, wird seinen 
Wert immer höher schätzen : er wird merken, mit welcher Ruhe und Sicherheit er jede, 
auch die schwerste gynäkologische Operation ausführen kann, wenn er das Gefühl hat, 
jeder unvorhergesehenen Blutung mit Leichtigkeit Herr zu werden. 

Ich habe vaginale und abdominale Uterusexstirpationen in den größten Kliniken 
Europas mit Erfolg ausgeführt (Paris: J. L. Faure; Leipzig: Sellheim; Wien: 
Halban ; Berlin: Stöckel; Halle: Nürnberger), ohne ein einziges Gefäß zu unter- 
binden und ohne eine Klemme zu hinterlassen, um die Wirkung des Tampons zu zeigen. 
Aus diesem Grunde glaubten einige Kollegen, daß ich meine Blutstillung als Methode 
der Wahl betrachte. Daß das nicht der Fall ist, habe ich in den vorstehenden Aus- 
führungen dargelegt. Ich betone nochmals, daß mein Tampon nur im Falle der Not 
bei anders nicht oder nur schwer zu stillenden Blutungen angewandt werden soll, 
dann aber eine sichere, nie versagende Hilfe bietet. 



1) Zbl. Gynäk. 1933, Nr. 14, 807. 



2) Küstner, Zbl. Gynäk. 1933, Nr. 13, 773. 



2. BUitstillungs;motho(lo für Notfälle nach Logothetopulos 




Abb. 10. i HU tstülungsmethode nach L.og<>t-hetopulo.s. Tampon in situ 



Abb. 11. DdntatittHngHinethodi 
nach Logothetopiilos. 
Starkes Anziehen der durch ein 
Ringpessar gezogenen Tanipon- 
zipfel nach unten. Die andere 
Hand drückt gleichzeitig das 
Pessar kräftig gegen die Vulva 




8 



Allgomoinor Teil 



Streifens, das zur Unterscheidung etwas länger sein muß als die vier Zipfel, fasse ich 
nun zusammen mit einer Amannschen Führungssonde und führe sie von der Bauch- 
höhle aus durch die S