15 4 EMIL NOVAK 



Herrmann^ who believed that he was thus able to isolate the active prin- 

 ciple of the ovary. 



Corpus Luteum Extract. T^his is procurable commercially in the 

 form of powder, capsules, tablets or aqueous solution. There has been 

 much discussion as to whether the extract should be obtained from the 

 ovaries of pregnant or of non-pregnant animals. It is difficult to decide 

 this question in the present state of our knowledge. Certainly the corpus 

 luteum reaches its fullest development during early pregnancy. On the 

 other hand, during pregnancy, menstruation is absent, suggesting that 

 perhaps the menstruation-producing hormone of the corpus luteum is 

 at this time held in abeyance. Osborne (&) does not believe that there is 

 any great difference between the effects of the extracts prepared from preg- 

 nant and non-pregnant animals. Seitz, Wintz and Fingerhut have shown, 

 in the case of beef ovaries, that the hormone activity of the corpus luteum 

 differs at different stages. They have isolated two separate substances 

 whose action is quite antagonistic, and each of which predominates at 

 different stages of the corpus luteum. One of these they call lipamin, 

 which is said to exert a stimulating effect on the growth of both the 

 internal and external generative organs. It is the predominant secretion 

 in the early corpus luteum, and its subcutaneous injection is said to bring 

 on the menstrual flow, in the case of amenorrheic women. The other sub- 

 stance, luteolipoid, predominates in the later stages of the corpus luteum, 

 and exerts an inhibiting effect on the menstrual period. These two sub- 

 stances have been prepared in tablet form in Germany, but, so far as I 

 know, not in this country. The question of the variations in the hormone 

 activity of the corpus luteum at its different phases is of obvious im- 

 portance from the standpoint of ovarian therapy, but comparatively little 

 of a definite nature is as yet known on this point. 



Soluble Extract of Corpus Luteum. This substance is worthy of 

 special mention because, within recent years, many clinicians have been 

 administering corpus luteum extract hypodermically in soluble form. The 

 substance is now conveniently prepared in ampoule form (1 c.c.), repre- 

 senting 20 mg. of the corpus luteum substance. For most indications it is 

 administered in doses of one ampoule every second or third day, but it 

 has been used much more frequently by some every day, or even twice 

 a day. The advantages of this form of administration are those which 

 pertain to hypodermic medication generally. It is precise, it enables the 

 physician to keep the patient under direct personal control, it avoids the 

 disagreeable digestive symptoms often associated with the oral method, 

 and it carries with it a psychic element which is lacking in medication 

 by the mouth. Hirst (a ) urges that the extract be injected deeply into the 

 muscles, preferably into the deltoid, claiming that it is too irritating for 

 injection into the subcutaneous tissue. Dannreuther speaks enthusi- 

 astically of the results of this form of ovarian therapy, stating that such 



