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CHAPTER 1 ANATOMY AND PHYSIOLOGY1

General Features1

Ovary4

Development and Physiology of the Ovary10

Ovulation15

Endocrine Relations Concerned in the Ovarian Cycle (by Willard Allen)32

Structures in the Broad Ligament43

Uterus45

Anatomy45

Physiology of the Uterus61

Menstruation61

Fallopian Tubes91

Physiology of the Tubes93

Pelvic Peritoneum96

Pelvic Connective Tissue97

Vagina99

Physiologic Changes in the Vagina102

External Genitals106

CHAPTER 2 GYNECOLOGIC EXAMINATION AND DIAGNOSIS117

Psychosomatic Aspects of Gynecology117

History121

Physical Examination122

Breast Examination124

Abdominal Examination124

Inspection of Abdomen124

Prominence of the Abdomen125

Palpation of Abdomen131

Percussion of Abdomen138

Auscultation of Abdomen139

Mensuration of Abdomen140

Examination of External Genitals and Adjacent Structures140

Dischange About External Genitals141

Vaginal Examination (Digital)144

Cervix Uteri146

Pericervical Tissues148

Pelvic Floor148

Vaginoabdominal Examination (Bimanual)149

Palpation of Body of Uterus150

Palpation of Lateral Regions of Pelvis157

Palpation of Other Regions160

Speculum Examination162

Rectoabdominal Palpation173

Localization of Backache176

Special Examinations177

Vaginal Smears and Surface Biopsy177

Colposcopic Magnification179

Schiller Test180

Cervical Biopsy182

Exploration of Endometrial Cavity183

Cul-de-Sac Puncture185

Pregnancy Tests186

Endocrine Investigations189

Gas Test for Tube Patency196

X-ray Examinations200

Pelvic Examination Under Anesthesia208

Intra-abdominal Inspection209

Urinary Tract Investigation212

Premarital Examination212

Differential Diagnosis214

Method in Diagnosis214

CHAPTER 3 DISEASES OF THE EXTERNAL GENITALS AND VAGINA222

Gonorrhea222

Gonorrhea in Children229

Gonorrhea After the Menopause231

Diseases of the Vulva231

Pruritus Vulvae231

Other Types of Vulvitis234

Ulcerative Diseases of Vulva and Vagina246

Nonmalignant Growths and Swellings of Vulva261

Malignant Disease of the Vulva273

Vulvovaginal Gland Diseases283

Diseases of the Vagina286

Injuries286

Vaginitis286

Nonmalignant Growths and Swellings in Vagina302

Malignant Disease of the Vagina305

Urethral Conditions308

Miscellaneous Disturbances312

CHAPTER 4 RELAXATION AND FISTULAE322

Point in Anatomy322

Relaxation of the Pelvic Floor325

Rectocele338

Cystocele338

Laceration of Sphincter Ani Muscle341

Rectovaginal Fistula349

Vesicovaginal Fistula351

CHAPTER 5 DISPLACEMENTS OF THE UTERUS358

Points in Anatomy358

Retrodisplacement of Uterus360

When the Uterus Is Movable366

When the Uterus Is Adherent376

Prolapse of Uterus378

Inversion of Uterus394

CHAPTER 6 INFLAMMATORY AND METABOLIC DISTURBANCES OF THE UTERUS395

Pelvic Congestion395

Acute Cervicitis396

Chronic Cervicitis397

Ulcer of Cervix422

Cervical Polyps429

Hypertrophy of Cervix431

Stricture of Cervix432

Hyperplasia of Endometrium432

Membranous Dysmenorrhea442

Acute Endometritis (Nonpuerperal)444

Puerperal Endometritis445

Chronic Endometritis446

Chronic Metritis446

Subinvolution of Uterus449

Hyperinvolution of Uterus453

Hypertrophy of Myometrium454

Senile Atresia of Uterine Canal455

Tuberculosis of Uterus456

Syphilis of Uterus459

Echinococcus Disease of Uterus460

Actinomycosis of Uterus462

CHAPTER 7 NONMALIGNANT TUMORS OF THE UTERUS464

Myoma of Uterus464

Pregnancy and Myoma493

Adenomyosis (Adenomyoma)496

Miscellaneous Growths499

Benign Tumors of the Cervix501

CHAPTER 8 CANCER OF THE UTERUS505

Etiology of Cancer505

Carcinoma of the Cervix Uteri507

Etiology of Cervical Cancer507

Pathology511

Intra-epithelial Carcinoma of the Cervix520

Early Diagnosis528

Pathology of Adenocarcinoma532

Treatment535

Radiation Therapy (by A．N．Arneson)537

Operative Treatment547

Prognosis548

Prevention549

Pregnancy With Cervix Cancer552

Carcinoma of the Corpus Uteri553

Etiology553

Pathology558

Symptoms and Diagnosis567

Treatment572

Prevention of Corpus Cancer576

Chorionepithelioma578

Sarcoma of the Uterus585

Pathology585

Treatment591

CHAPTER 9 PELVIC INFLAMMATION595

Introduction595

Acute Pelvic Inflammation596

Chronic Pelvic Inflammation610

Chronic Salpingitis610

Chronic Pelvic Cellulitis (Parametritis)626

CHAPTER 10 OTHER DISEASES633

Extrauterine Pregnancy633

Other Pelvic Hemorrhages655

Tubal Tuberculosis657

Tumors of Fallopian Tubes665

Torsion of Adnexa670

Varicose Veins of Broad Ligament671

Miscellaneous Rare Conditions672

CHAPTER 11 DISEASES OF THE OVARY AND PAROVARIUM685

Clinical Classification685

Congenital Anomalies687

Prolapse of Ovary689

Infection of Ovary690

Disturbances of Follicular Function691

Ovarian Tumors701

Benign Growths701

Proliferating Cysts702

Dermoid Cysts710

Symptoms and Diagnosis of Ovarian Cysts in General713

Complications715

Treatment of Proliferating and Dermoid Cysts718

Ovarian Tumors in Children718

Benign Solid Tumors719

Malignancies of the Ovary723

Malignant Tumors Arising From Ovarian Mesenchyma735

With Endocrine Influence735

With No Endocrine Influence747

Miscellaneous Rare Tumors749

Tumors of the Uterine Ligaments750

Tumors Due to Transplantation or Heteroplasia753

CHAPTER 12 MALFORMATIONS773

Points in Development773

Anomalies of Development775

Types of Anomalies777

CHAPTER 13 MENSTRUAL DISTURBANCES807

Disturbances of Function807

Menstrual Disturbances808

Menorrhagia and Metrorrhagia808

Treatment-Investigation Program808

Irregular Menstruation822

Precocious Menstruation822

Vicarious Menstruation823

Intracyclic Bleeding823

Absence of Menstruation (Amenorrhea)823

When the Patient Has Never Menstruated824

When the Patient Has Menstruated826

Painful Menstruation (Dysmenorrhea)836

Premenstrual Tension849

Menstrual Headache850

Intermenstrual Pain and Spotting851

Menstrual Pruritus851

CHAPTER 14 STERILITY AND SEXUAL DISTURBANCES855

Sterility855

Contraception872

Sterilization873

Dyspareunia874

Sexual Frigidity877

Sexual Hyperesthesia878

CHAPTER 15 MISCELLANEOUS DISTURBANCES880

Climacteric Disturbances880

Endocrine Changes881

Other Disturbances Associated With the Climacteric885

Menopause Disturbances886

Allergic Disturbances888

Breast Considerations891

CHAPTER 16 MEDICOLEGAL POINTS IN GYNECOLOGY896

Rape896

Other Conditions905