Daniel G. Morton

A comparative study of male and female pelves in children with a consideration of the etiology of pelvic conformation

Abstract The pelves of 59 girls and 16 boys between the ages of 5 and 15 years were studied roentgenologically by a modification of the Thoms method. In 42 (71.2 per cent) of the girls and in all of the boys, the pelvic inlet was anthropoid or dolichopellic in type. In 10 other girls, while the pelves were not of the pure anthropoid type, marked anthropoid characteristics were observable. In all except one of the children of pre-puberty age (11 years or less), both girls and boys, the pelvic inlet was essentially anthropoid in type. Uniformly these inlets exhibited an inward bulge in the regions of the acetabula. The pelves of the prepubertal children were indistinguishable with respect to sex, except for a possible difference in the position of the greatest transverse diameter of the inlet. In the children of post-pubertal age, there were definite developments in the pelves which distinguished them from those of the younger children; there were also marked differences between the pelves of the two sexes.

The cause of death in patients treated for cervical cancer

Abstract In analyzing the results of the treatment of cancer the usual approach is to evaluate the number of five-year cures with respect to the various forms of therapy. It was felt that an opposite approach, i.e., an analysis of the failures of treatment might reveal equally important information and that is the principal method of attack in this study. Such questions as the following need to be answered: Why do patients die after treatment for cancer? Is it because the growth was too extensive to hope for a curative irradiation response, or a complete surgical removal? Do the patients die because of the local persistence and growth of cancer, or because of lymph node or other metastases? How long do patients live after treatment for cancer? When death occurs after five years, is it because of other disease, other cancer, or recurrence of the original disease? If it is recurrence, is death due to persistent local disease or to metastases which were already present at the time of treatment? Can the role of lymph node metastasis be more precisely defined than it now is? Why is it that some patients with early lesions die very shortly after treatment and others with advanced growth survive for a long period of time? Can deficiencies in treatment explain the early deaths in early cases? The present study cannot begin to answer all of these questions, but posing them helps to indicate the direction of thought.

Observations upon the role of the sex hormones in the development of bony pelvic conformation

Abstract The bony pelves of 13 males and 5 females who exhibited the absence of secondary sexual characteristics because of disease or deficiency of the anterior pituitary gland, or because of absence or functional deficiency of the gonads, were studied roentgenologically. In all instances some of the characteristics appropriate for the particular sex were observed, though in not a few stigmas of incomplete development and characteristics of the opposite sex were present also. It was concluded that the sex hormones are not the primary determinants of the sexual characteristics of the bony pelvis, though it was conjectured that they may aid in the maturation of the pelvis in the proper direction, and, indeed, the possibility of the variations in the shape of adult pelves sometimes being on a hormonal basis cannot be dismissed.

Modern prenatal care

Abstract Prenatal care is an essential feature of good obstetrical care. If one wishes to convince himself of the value of prenatal care by cold, hard figures he need only consult the reports of maternal mortality in Philadelphia (1931–1933), 9 the Fifteen States report, 10 and others of similar nature. All show that maternal deaths are associated with inadequate or no antenatal care in a large percentage of the cases. Having consulted her physician and being willing to cooperate, the patient has done her part, in a manner of speaking. It is then up to the physician to see that she gets the benefit of proper examination and care according to the principles set forth. Proper prenatal care involves: 1. 1. Medical care from a very early period of pregnancy, in case continuance of the pregnancy is inadvisable; 2. 2. Complete history and physical examination, both general and obstetrical, in order that the patients physical status may be fully appreciated, and in order that the development of abnormalities may be anticipated as much as possible; 3. 3. Acquaintance of the patient with the danger signals, in order that she may call her doctor at once; 4. 4. Instruction of the patient regarding the proper regulation of diet, exercise, rest, bowels, sexual intercourse, and general mode of living; 5. 5. Regular follow-up examinations becoming more frequent as term is approached, in order that the physician may discover deviations from the normal as early as possible; 6. 6. Appreciation of the complications which are more or less closely related to pregnancy, their suggestive symptoms, methods of diagnosis, in order that they may be forestalled or treated in their very early stages. The complications referred to are syphilis, gonorrhea, pyelitis, hyperemesis, the late toxemias of pregnancy and hemorrhage, particularly. 7. 7. Knowledge of the minor complications and what may be done for them.

Anatomic description of a case of marginal placenta previa

Abstract An anatomic description of a case of marginal placenta previa is presented. Interesting findings were: marked scarcity of decidua beneath the placenta, relatively profuse decidual reaction in the cervix and lower uterus, and presence of a circular sinus at the level of the internal os. The implications of these findings regarding etiology, frequency, the cause of bleeding, and the lower uterine segment are discussed.