CHAPTER 1 ANATOMY AND PHYSIOLOGY 1
General Features 1
Ovary 4
Development and Physiology of the Ovary 10
Ovulation 15
Endocrine Relations Concerned in the Ovarian Cycle (by Willard Allen) 32
Structures in the Broad Ligament 43
Uterus 45
Anatomy 45
Physiology of the Uterus 61
Menstruation 61
Fallopian Tubes 91
Physiology of the Tubes 93
Pelvic Peritoneum 96
Pelvic Connective Tissue 97
Vagina 99
Physiologic Changes in the Vagina 102
External Genitals 106
CHAPTER 2 GYNECOLOGIC EXAMINATION AND DIAGNOSIS 117
Psychosomatic Aspects of Gynecology 117
History 121
Physical Examination 122
Breast Examination 124
Abdominal Examination 124
Inspection of Abdomen 124
Prominence of the Abdomen 125
Palpation of Abdomen 131
Percussion of Abdomen 138
Auscultation of Abdomen 139
Mensuration of Abdomen 140
Examination of External Genitals and Adjacent Structures 140
Dischange About External Genitals 141
Vaginal Examination (Digital) 144
Cervix Uteri 146
Pericervical Tissues 148
Pelvic Floor 148
Vaginoabdominal Examination (Bimanual) 149
Palpation of Body of Uterus 150
Palpation of Lateral Regions of Pelvis 157
Palpation of Other Regions 160
Speculum Examination 162
Rectoabdominal Palpation 173
Localization of Backache 176
Special Examinations 177
Vaginal Smears and Surface Biopsy 177
Colposcopic Magnification 179
Schiller Test 180
Cervical Biopsy 182
Exploration of Endometrial Cavity 183
Cul-de-Sac Puncture 185
Pregnancy Tests 186
Endocrine Investigations 189
Gas Test for Tube Patency 196
X-ray Examinations 200
Pelvic Examination Under Anesthesia 208
Intra-abdominal Inspection 209
Urinary Tract Investigation 212
Premarital Examination 212
Differential Diagnosis 214
Method in Diagnosis 214
CHAPTER 3 DISEASES OF THE EXTERNAL GENITALS AND VAGINA 222
Gonorrhea 222
Gonorrhea in Children 229
Gonorrhea After the Menopause 231
Diseases of the Vulva 231
Pruritus Vulvae 231
Other Types of Vulvitis 234
Ulcerative Diseases of Vulva and Vagina 246
Nonmalignant Growths and Swellings of Vulva 261
Malignant Disease of the Vulva 273
Vulvovaginal Gland Diseases 283
Diseases of the Vagina 286
Injuries 286
Vaginitis 286
Nonmalignant Growths and Swellings in Vagina 302
Malignant Disease of the Vagina 305
Urethral Conditions 308
Miscellaneous Disturbances 312
CHAPTER 4 RELAXATION AND FISTULAE 322
Point in Anatomy 322
Relaxation of the Pelvic Floor 325
Rectocele 338
Cystocele 338
Laceration of Sphincter Ani Muscle 341
Rectovaginal Fistula 349
Vesicovaginal Fistula 351
CHAPTER 5 DISPLACEMENTS OF THE UTERUS 358
Points in Anatomy 358
Retrodisplacement of Uterus 360
When the Uterus Is Movable 366
When the Uterus Is Adherent 376
Prolapse of Uterus 378
Inversion of Uterus 394
CHAPTER 6 INFLAMMATORY AND METABOLIC DISTURBANCES OF THE UTERUS 395
Pelvic Congestion 395
Acute Cervicitis 396
Chronic Cervicitis 397
Ulcer of Cervix 422
Cervical Polyps 429
Hypertrophy of Cervix 431
Stricture of Cervix 432
Hyperplasia of Endometrium 432
Membranous Dysmenorrhea 442
Acute Endometritis (Nonpuerperal) 444
Puerperal Endometritis 445
Chronic Endometritis 446
Chronic Metritis 446
Subinvolution of Uterus 449
Hyperinvolution of Uterus 453
Hypertrophy of Myometrium 454
Senile Atresia of Uterine Canal 455
Tuberculosis of Uterus 456
Syphilis of Uterus 459
Echinococcus Disease of Uterus 460
Actinomycosis of Uterus 462
CHAPTER 7 NONMALIGNANT TUMORS OF THE UTERUS 464
Myoma of Uterus 464
Pregnancy and Myoma 493
Adenomyosis (Adenomyoma) 496
Miscellaneous Growths 499
Benign Tumors of the Cervix 501
CHAPTER 8 CANCER OF THE UTERUS 505
Etiology of Cancer 505
Carcinoma of the Cervix Uteri 507
Etiology of Cervical Cancer 507
Pathology 511
Intra-epithelial Carcinoma of the Cervix 520
Early Diagnosis 528
Pathology of Adenocarcinoma 532
Treatment 535
Radiation Therapy (by A．N．Arneson) 537
Operative Treatment 547
Prognosis 548
Prevention 549
Pregnancy With Cervix Cancer 552
Carcinoma of the Corpus Uteri 553
Etiology 553
Pathology 558
Symptoms and Diagnosis 567
Treatment 572
Prevention of Corpus Cancer 576
Chorionepithelioma 578
Sarcoma of the Uterus 585
Pathology 585
Treatment 591
CHAPTER 9 PELVIC INFLAMMATION 595
Introduction 595
Acute Pelvic Inflammation 596
Chronic Pelvic Inflammation 610
Chronic Salpingitis 610
Chronic Pelvic Cellulitis (Parametritis) 626
CHAPTER 10 OTHER DISEASES 633
Extrauterine Pregnancy 633
Other Pelvic Hemorrhages 655
Tubal Tuberculosis 657
Tumors of Fallopian Tubes 665
Torsion of Adnexa 670
Varicose Veins of Broad Ligament 671
Miscellaneous Rare Conditions 672
CHAPTER 11 DISEASES OF THE OVARY AND PAROVARIUM 685
Clinical Classification 685
Congenital Anomalies 687
Prolapse of Ovary 689
Infection of Ovary 690
Disturbances of Follicular Function 691
Ovarian Tumors 701
Benign Growths 701
Proliferating Cysts 702
Dermoid Cysts 710
Symptoms and Diagnosis of Ovarian Cysts in General 713
Complications 715
Treatment of Proliferating and Dermoid Cysts 718
Ovarian Tumors in Children 718
Benign Solid Tumors 719
Malignancies of the Ovary 723
Malignant Tumors Arising From Ovarian Mesenchyma 735
With Endocrine Influence 735
With No Endocrine Influence 747
Miscellaneous Rare Tumors 749
Tumors of the Uterine Ligaments 750
Tumors Due to Transplantation or Heteroplasia 753
CHAPTER 12 MALFORMATIONS 773
Points in Development 773
Anomalies of Development 775
Types of Anomalies 777
CHAPTER 13 MENSTRUAL DISTURBANCES 807
Disturbances of Function 807
Menstrual Disturbances 808
Menorrhagia and Metrorrhagia 808
Treatment-Investigation Program 808
Irregular Menstruation 822
Precocious Menstruation 822
Vicarious Menstruation 823
Intracyclic Bleeding 823
Absence of Menstruation (Amenorrhea) 823
When the Patient Has Never Menstruated 824
When the Patient Has Menstruated 826
Painful Menstruation (Dysmenorrhea) 836
Premenstrual Tension 849
Menstrual Headache 850
Intermenstrual Pain and Spotting 851
Menstrual Pruritus 851
CHAPTER 14 STERILITY AND SEXUAL DISTURBANCES 855
Sterility 855
Contraception 872
Sterilization 873
Dyspareunia 874
Sexual Frigidity 877
Sexual Hyperesthesia 878
CHAPTER 15 MISCELLANEOUS DISTURBANCES 880
Climacteric Disturbances 880
Endocrine Changes 881
Other Disturbances Associated With the Climacteric 885
Menopause Disturbances 886
Allergic Disturbances 888
Breast Considerations 891
CHAPTER 16 MEDICOLEGAL POINTS IN GYNECOLOGY 896
Rape 896
Other Conditions 905