1907.] Correlation of the Ovarian and Uterine Functions. 391 



that when the body of the uterus was removed, entire atrophy of the 

 ovaries always followed, so that menopausal symptoms set in similar to 

 those occurring after oophorectomy. In three cases, however, in which a 

 portion of the uterine mucous membrane was conserved, menstruation 

 persisted and menopausal symptoms were absent. 



Doran (1905), after following up the after-history of 60 cases of sub-total 

 hysterectomy, is inclined to support Abel and Zweifel, in that the uterus 

 should be removed above the cervix, in order to prevent sudden artificial 

 menopause, while he also cites two cases where menstruation persisted 

 after removal of the body of the uterus and both ovaries, the cervix being 

 left behind. 



Mandl and Burger (1904) in an exhaustive monograph on the effects of 

 hysterectomy with and without the ovaries hold that in those cases in which 

 the ovaries are left behind there is a gradual cessation of ovarian function due 

 to atrophy or degeneration of the ovaries. 



Holzbach (1906), however, states that, as a rule, the ovaries do not 

 degenerate after hysterectomy, and that where such degeneration does occur 

 it is probably due to the interference with the nervous connections consequent 

 upon the operation of removal. 



Blair Bell (1906) holds that the theory of the internal secretion of the 

 ovary is inconclusive, and that the clinical facts go to show that menstruation 

 is due to a uterine secretion, and the menopause due to its absence, while he 

 supposes ovulation itself to depend on the circulation of this secretion, which 

 he calls " uterin." He mentions that there have been many cases in the 

 Royal Infirmary at Liverpool in which ordinary menstruation continued after 

 the removal of the ovaries, and makes further statements pointing to the 

 conclusion that the ovaries invariably atrophy after the removal of the uterus. 



Bond (1906), on the other hand, believes that the ovarian secretion is 

 influenced by a saline secretion from the endometrium, the two, however,, 

 acting antagonistically to one another, so that prevention of the uterine 

 secretion by hysterectomy favours hypertrophy of the ovary. Bond's view, 

 therefore, is diametrically opposite to that of Blair Bell. 



Bond records two experiments on the results of hysterectomy. In one of 

 these the entire uterus of a rabbit was removed and the animal killed after 

 five months. Both ovaries were found to be normal. In the other experiment 

 the left uterine cornu only was extirpated and the rabbit killed after five- 

 months. The ovaries in this case also were in no way atrophied. Bond 

 expresses the belief that the prevention by previous hysterectomy of the 

 secretion of the saline fluid by the endometrium of the ancestrous uterus* 

 favours the overgrowth of luteal tissue in the ovary. 



