S IMPI,ICITY is art. If, therefore, by reviewing the facts adduced from several years of constant research in the subject of sterility we can finally arrive at a simplified method of studying the individual case which reduces the distasteful elements of such study to a minimum, both for the physician and for the patient, and also outline a shortcut procedure for determining the lesion interfering with conception, we shall feel that we have attained one of the essentials of a perfected technic. The study of sterility has many discouraging features. Much clinical experience has been accumulated and often it is contradictory. Exceptions are hard to account for; many preconceived impressions are reluctantly abandoned, and, finally, the percentage of cures which we can honestly claim, is small. Two years ago I was visited by a gynecologist of another city who asked me why I had published so little lately on the subject of sterility. I replied, with some emphasis, that I was discouraged with the work, that I knew little about it anyway, and did not propose to write until I had something definite to say. While the general results of my work still seem meager, spectacular success occurs from time to time, and a review of the individual cases during recent years discloses facts about results which are interesting and promising. My study showed that by far the larger proportion of patients were hopeless from the start. But hope springs eternal regarding fertility. Many patients 1vere older than forty. Once a physician of sixty-five from a neighboring state, came with his wife of fifty-two. Another large group is made up of cases of male deficiency, and this :finding frequently terminates the case. Not a small proportion of cases were those presenting frank histories of gonorrheal pathology. Of the lat. ter group I am at present taking a more hopeful view, for reasons which I expect to outline in a later paper. Still a smaller group, but one I approach with little enthusiasm, is that of patients who give a suspicious history of morbidity following a useless curettage. Curetting has no place in the treatment of sterility except as a means of examination when symptoms suggest a diseased endometrium. Constantly I hear in my office, ''The doctor found nothing wrong with me so he said he would operate and scrape the womb." The members of this society do not need to be instructed, but as teachers and consultants
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