Integrated Gynecology. Principles and Practice

These three handsome volumes, written in the European tradition, represent a commendable and ambitious undertaking, original in that considerable effort is made to integrate gynecology with the broader aspects of medicine. Volume I commences with chapters on the anatomy and evolution of the female pelvic organs with considerably more extensive accounts than are found in most texts. The chapters on physiology, including endocrinology, and on gynecological diagnostic procedures are also very comprehensive. The section on tubal insufflation and hysterosalpingography is, needless to say, authoritative. It seems a little surprising that a book published in 1956 should still see merit in the Richardson pregnancy or sex differentiation tests. There follow sections on congenital anomalies and a listing of mechanical and chemical injuries (some of which are only distantly related to the female reproductive system). Lengthy descriptions of various displacements of the pelvic viscera precede a chapter on infections. Volume II classifies the various tumors of the female sex organs with very complete pathological descriptions and illustrations. The microphoto-graphs are of variable quality, but on the whole demonstrate the pathological processes satisfactorily. The volume also covers constitutional disorders and problems of reproduction, including a competent section on sterility. Volume III commences with a chapter on the relationship between reproductive and other body systems. Unfortunately, the effort is made to list, rather than sort, the important from the unimportant. For example, a full page is devoted to the role of the nose in dysmenorrhea and labor pains, but one sentence covers German measles in relation to pregnancy and two cover the role of oxygen in retrolental fibroplasia. There is no discussion of the pre-and post-operative care of the diabetic, or mention of the relationship of diabetes to endometrial carcinoma. The breast and urinary tract are regarded as an intimate part of gynecology and are covered rather extensively. Pelvic bowel lesions are, in comparison, slighted. The chapter on gynecological symptomatology is a little redundant with terms such as "proiopolymenorrhea," "a1gomenorrhea," "oligo-opsomenorrhea," "fluor," and others. There is a good collection of operative illustrations in the chapter on operative gynecology. However, there is unwarranted support given to subtotal hysterectomy; the Witzel enterostomy is recommended for intestinal distention or for peritonitis; and the implication that lymph node dissection is not always necessary in the Wertheim operation is supported by the surprising statement that "it became clear that lymph nodes can destroy cancer cells." The chapter on physiotherapy …