Howard C. Taylor

The relationship of the estrogens and other placental hormones to sodium and potassium balance at the end of pregnancy and in the puerperium

Abstract Two distinct general conceptions of the nature and origin of the toxemias of pregnancy have guided recent research in two apparently quite divergent channels. In one direction are the endocrines, a very promising field, for it seems hardly possible that the substances which determine to such an extent the characteristic physiologic changes of pregnancy should not be in some sense responsible for a disease which occurs only in pregnancy. On the other hand are the physical and chemical phenomena of water and electrolyte exchange, which for the moment seem more closely related to the classical symptoms and signs of pre-eclamptic toxemia. Recent experiments showing that the estrogens and progesterone may cause the retention of sodium and of water suggest a line of investigation by which the hormonal and the physicochemical conceptions of toxemia may perhaps be reconciled. The precise intention of this study has been to determine whether in pregnancy changes in the concentration of the estrogens and other placental hormones have any effect on the retention and excretion of sodium and potassium. The general method of investigation has been the measurement of the balance of sodium and potassium intake and output during alterations in the hormone content of the blood and the urine. The changes in hormone concentration made use of have been those occurring at parturition, after intrauterine death of the fetus and those following the intramuscular injection of estrogenic substances.

Symptoms and treatment of follicle cysts of ovary

Abstract With an ovarian mass under 5 cm. in diameter in women before the menopause, the probability of the ovarian condition being benign is so great that a period of observation is indicated. Such a period of observation with only general methods of treatment must be undertaken and persisted in for a variable period of time, depending on the severity of the symptoms, before any operation is justifiable. It is doubtful whether any of the hormone preparations now available will have any effect on the cystic ovary or on the evidences of ovarian dysfunction associated with the cystic ovary. It is even possible that the anterior pituitary or anterior pituitary-like hormones may be definitely detrimental. X -ray or radium therapy has a definite place in the treatment of these conditions. In the first place these agents are specifically indicated in the hyperplasias of the endometrium preceding the menopause which are believed to be dependant upon the presence of abnormal numbers or forms of follicles. X -rays or radium may also be of use in the treatment of the cystic changes developing after a hysterectomy, salpingectomy or previous ovarian operations. Surgical treatment is indicated in the presence of associated disease of the adnexa or the uterus. A suspension of a retroverted or prolapsed uterus, by improving the circulation of the pelvis, may relieve congestion in the ovary and remove one of the causes of cystic disease. Salpingectomy for pelvic inflammation may also be beneficial but carries with it the danger of injury to the blood supply of the ovary and according to one theory may itself predispose to cystic follicles. Direct surgical attack on the cystic ovary itself is rarely necessary. With major menstrual disturbances, particularly in the form of long periods of amenorrhea, the partial resection of enlarged cystic ovaries may be of benefit. Under any circumstance it must be constantly borne in mind that the multiple follicle cysts of the ovary and the related cystic corpora lutea are not new growths but are instead the structural evidence of an unusual or abnormal function. These conditions must be approached therefore with the intent to restore normal function rather than to eliminate truly diseased tissues.