A HORMONE FOR GESTATION 



is being scientific he is (if the drug is really useful) condemn- 

 ing half his patients with threatened abortion to the risk of 

 losing their babies — a dilemma similar to that dramatically 

 expounded in Sinclair Lewis's great novel of medical life, 

 Arrowsmith. A clever method of testing this question was 

 recently suggested by the British physicians Malpas, Mc- 

 Gregor and Stewart, who pointed out that women who are 

 unfortunate enough to have three or more successive spon- 

 taneous abortions are (statistically speaking) almost certain 

 to miscarry in the next subsequent pregnancy. If, then, any 

 kind of treatment is followed by the birth of a living infant, 

 the odds are great that the medical procedure, and not mere 

 chance, was responsible. By this severely critical test, it 

 appears that progesterone is saving some of these babies. 

 Needless to say, a treatment which is still so largely experi- 

 mental requires skilled and thoughtful handling, by physicians 

 thoroughly familiar with the proper dosage and other prob- 

 lems. 



Post partum pain. The most clear-cut use of progesterone 

 involving its sedative action on the uterine muscle is for the 

 relief of spasmodic pain due to excessive contractions of the 

 uterus after childbirth. This is sometimes severe enough to 

 require relief. Lubin and Clarke, of Brooklyn, found that a 

 single dose of one international unit of progesterone will 

 relieve these afterpains in about 90 per cent of the cases. 



Menstrual cramps. Painful menstruation is one of the com- 

 monest of human ills, and one of the least understood. Know- 

 ing as little as we do about normal menstruation, it is no 

 wonder that we also know all too little about its disturbances. 

 In the case of painful menstruation (dysmenorrhea) we are 

 not even sure of the exact seat of the pain in all cases. It is 

 probably due to cramping of the muscular wall of the uterus ; 

 but there is reason to think that in some cases the pain may 

 be produced in the lining of the uterus rather than in the mus- 

 cular substance of the wall. All sorts of treatment have been 



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