OVARIAN GRAFTING IN MAN. 7 



Dauber (1905) shows how difficult it is, especially in disease, to assert 

 with confidence that all ovarian tissue has been removed. 



Dudley (1900) cites several cases of pregnancy after ovariotomy. 



Croom (1905) reports a case of homoplastic ovarian graft, with four years 

 later the birth of a living - child. Obviously it is impossible to verify such 

 cases as this, and they must always remain open to doubt unless the child in 

 question shows some strongly inherited and dominant characteristic which 

 was possessed by the individual who supplied the graft, but not by the 

 foster-mother or by the father. Such conditions are not likely often to be 

 realized in clinical experience, hence our principal reliance for determin- 

 ation of the theoretical questions involved must be animal experimentation. 



Morris (1906), who had done much successful clinical work on autograft - 

 ing, besides some early experimental work, reported the birth of a living 

 child in a woman into whom, after careful castration with the Tuffier angio- 

 tribe, he had grafted wedges of ovary from another woman. The castrated 

 ovaries of the woman who was grafted were cirrhotic, and no formed 

 Graafian vesicles were found. It was assumed that the introduced ovarian 

 tissue was responsible for the result reported; but Lucas-Championniere, 

 criticizing this case, has expressed the view that it can be given another 

 interpretation. He cites as an example a patient of his own, in whom, after 

 the most careful castration with the angiotribe for a case of dysmenorrhea, 

 the symptoms still persisted. A second operation on this patient, over a 

 year later, revealed an important ovarian fragment at the uterine horn. 



Glass (1899) gives a convincing case of homoplastic operation in a woman 

 who two years before had had ovariotomy performed. She was suffering 

 from all the symptoms of an artificial menapause, but a graft from another 

 woman relieved her. The relief appears to have been permanent. No 

 children are reported. 



Mauclaire (1900) collected thirteen cases of homoplastic operation in 

 women. In six of these cases menstruation returned, and in two cases it 

 was resumed temporarily. The persistence and functioning of the intro- 

 duced tissue is, however, in no case established beyond question. On the 

 whole, Mauclaire regards ovarian transplantation as of doubtful clinical 

 value. 



Sauve (1910) sums up in a very clear and direct way all the surgical evi" 

 dence at hand. His statistics show that return of menstruation is no more 

 common after ovarian grafting than after ovarian castration. There are, 

 he thinks, only two cases of successful homoplastic grafting in women. 

 The first case is that reported by Morris, in which a woman with infantile 

 ovaries became normal and had regular menstruation after the transfer of 

 ovarian tissue from another woman; and the second case is that of Pankow, 

 which is supported by definite histological evidence after a period of three 

 years. 



