Willis E. Brown

A study of the physiologic action of human chorionic hormone

Summary 1. Human chorionic hormone is luteotrophic in women and will induce a pseudopregnant condition, as evidenced by a prolongation of the functional life of the corpus luteum, the development of a decidua, and the prolonged excretion of pregnanediol. 2. The effective dose of chorionic hormone seems to be 5,000 I.U. to 10,000 L U. daily. These doses may be given without untoward reactions. 3. Until objective evidence of other gonadotrophic action in women is obtained, the use of human chorionic hormone should be directed toward the maintenance or augmentation of luteal function.

The vaginal smear in population screening for uterine carcinoma

Abstract A technique was devised to obtain a sample of the vaginal discharge easily, quickly, and at low unit cost. Vaginal smears were taken on 5,314 women representing three population segments: general hospital admissions, institutional inmates, and the female population of an Iowa county. The established clinical and histologic methods of diagnosing genital malignancy were used to determine the efficiency of the vaginal smear as a population screening procedure. The cytologic examination has proved to be of value when used in this manner.

Morphine suppression of urinary output in pregnant and nonpregnant women

Abstract 1. Eleven normal nonpregnant and four normal pregnant women and two patients with diabetes insipidus were given intravenous infusions of 5 per cent dextrose and their urinary outputs were measured for twenty-four hours. After several days, the procedure was repeated with the patient receiving morphine sulphate, 1/4 grain (16 mg.), intramuscularly at the time the intravenous infusion was begun. The results obtained on the control day were compared with those obtained on the morphine day. 2. During the intravenous administration of 5 per cent dextrose at a constant rate over a five-hours period in normal subjects, there is an initial diuresis in the first two hours followed by a decrease in urinary output. 3. A single dose of morphine caused a suppression of urinary output which tended to eliminate the initial diuretic surge normally seen in the first two hours. This was a constant effect but varied in degree. 4. On morphine test days, as compared with control days, there was no increase of specific gravity or chloride concentration of the urine. Hematocrit determinations taken before the infusion and again eight hours later were unchanged during both control and morphine days. 5. Two patients, one pregnant, were given single injections of Pitressin. There was an increased concentration of urinary chlorides and an increase in total chlorides. One patient had suppression of urinary output and the other showed an output about equal to that on the control day. 6. Two patients with diabetes insipidus demonstrated suppression of urinary output when given morphine. In one instance the total chlorides were decreased and in the other they remained unchanged. 7. These observations suggest that the data from dog experiments, indicating that morphine causes a release of antidiuretic hormone from the neurohypophysis, cannot be accepted in explanation of the antidiuretic effect of morphine in normal women.

Single injection caudal for obstetrical analgesia and the use of pontocaine

Abstract 1. This report details observations on single injection pontocaine caudal anesthesia in labor and delivery. 2. A technique is described by which the volume of the caudal and epidural space can be estimated by injecting 1 per cent procaine solution thus permitting the injection of the proper amount of pontocaine solution. 3. Analgesia lasting from three to five hours may be obtained by single injections of pontocaine solution. 4. The relief of pain during labor and delivery is satisfactory when adequate levels of anesthesia are obtained. 5. This single injection technique is clinically easier than the continuous methods.

Adrenogenital pseudohermaphroditism treated with stilbestrol

Summary A patient who has adrenogenital pseudohermaphroditism is reported. The attempt which was made to demasculinize this patient by the administration of stilbestrol and the results of this attempt are discussed.