A HORMONE FOR GESTATION 



the latter do not menstruate and in pregnancy they differ in 

 many ways. It will be clear enough when we deal with the 

 menstrual cycle, in Chapter VI, that we do not even yet fully 

 understand the way the ovarian hormones take part in men- 

 struation. We know that the monthly cycle and the process of 

 gestation require not only the individual hormones but also 

 an exact balance between them. When these things go wrong, 

 they do so in complex and devious ways. When a young wo- 

 man is cramped with menstrual pain or a wife goes childless 

 against her will, in many cases neither her physician nor the 

 investigator in his laboratory can say exactly what is wrong 

 or how to redress it. They can only try their best ; often the 

 treatment works, often not. Only by the slow pathway of 

 experiments on monkeys and cautious observation and trial 

 directly in humans shall we ever comprehend the normal physi- 

 ology of reproduction in our own species and those vexatious, 

 oftentimes tragic disturbances that lead to disorders of men- 

 struation, miscarriage, and sterility. 



It is therefore only in small degree possible as yet to apply 

 progesterone and estrone, and the other potent steroidal 

 hormones, to human disease. We must leave the problem in 

 the hands of competent gynecologists and obstetricians, par- 

 ticularly in the clinics of the medical schools and research 

 hospitals. When these men give the word, hormone treatment 

 becomes justifiable. The work is going forward daily; I do 

 not mean to be discouraging, but only to avoid false promises 

 of quick magic like that of insulin. Incidentally some cases 

 of diabetes still defy insulin, and the specialists in that disease 

 have by no means been able to declare their treatment per- 

 fected and their researches complete. 



The maintenance of pregnancy. What can we hope for from 

 progesterone in the long run ? The great dramatic thing about 

 this hormone as seen in the laboratory is of course its power 

 to maintain pregnancy after the loss of ovarian function. One 

 of the greatest problems of medical practice is that of spon- 



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