No abstract

tainly do not show hyperplasia in the sense in which gynecologic pathologists use the term. But there is no doubt, on the basis of considerable experimental evidence, that such a condition can be reproduced. I believe that the authors' results would be more clearly denned if they did not interrupt their study so frequently by the disturbing factor of curettage. Such studies as these add additional evidence in support of the broad prin¬ ciple that functional uterine bleeding, including that of normal menstruation, is due to a withdrawal or abrupt diminution in the level of the folliculin content of the blood. If a maturing follicle or a maturing corpus luteum is excised, bleeding results after an interval of varying length. If a castrated animal is given theelin daily for seven or eight days, bleeding results, but not until some days after the withdrawal of the theelin.I have elsewhere summarized the evidence for this rather fundamental principle in the causation of uterine bleeding and have discussed also the equally important rôle played by the reciprocal effects of the ovary and the anterior hypophysis. The authors mentioned that in some cases evidences of hypersecretion were seen in the endometrium after the injection of theelin. This is contrary to accepted ideas, if they mean a real secretory activity of the epithelium such as is found in the pregravid or secretory phase of the cycle. Indeed, one of the criteria in the microscopic diagnosis of hyperplasia of the endometrium is the absence of any secretory activity.Dr. J. P. Pratt, Detroit : Dr. Werner and Dr. Collier have opened the possibility of many problems for discussion. Among the most important of these is the demonstration of concrete anatomic and physiologic evidence of reaction to theelin by the human ovary. This contribution is especially welcome in view of the fact that animal experimentation with hormones has advanced far beyond the clinical application and that results of animal reactions have been applied by analogy to clinical problems with frequent unsatisfactory consequences. Among animals, many striking variations appear in their reaction to hormones, even in closely related species. This demonstration of reaction in the human subject, therefore, is extremely valu¬ able. Separation of their objective from their subjective evi¬ dence is most important, for the latter is difficult to evaluate. For this reason, observation of a change in such symptoms as libido may be open to question. How much of the change was due to psychotherapy? Reports of attempts to substitute for ovarian deficiency are numerous, but the authors hold a unique position in reporting unquestionable evidence of reaction to ovarian hormone in a series of cases in which the ovaries were absent. Even in their series considerable individual variation in response to a given dosage was noted. This emphasizes the difficulty of estimating the amount of hormone needed to sub¬ stitute for deficiency when the ovaries are present but are not functioning normally. There is no satisfact...

No abstract

No abstract

No abstract