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This paper is based on the management of the labor in 6,000 women about equally divided among Caucasian and Negro. Most were clinic patients who had inadequate antepartum care and many none at all. Some came from a great distance and had been neglected in long preliminary labor, often accompanied by unsterile vaginal examinations.Uppermost in the therapy of each individual case was the ambition to recover a live and uninjured mother, but early in the series more and more interest was taken in the care of the fetus, and time and energy were counted as not wasted in devising methods to enhance its welfare and, in spite of its often bleak cultural and economic outlook, to saving it in addition to the mother. The fullest satisfaction was derived from obtaining a live mother and a live and healthy infant where the outlook was most hopeless. These methods, most of

1.1. The incidence of fibromyomas in Negro women residing in the neighborhood of Augusta, Georgia, is three and one-third times that of white women.2.2. Sixty per cent of white women had tumors smaller than 5 cm. in diameter. Sixty-six per cent of the Negro women had tumors larger than 5 cm. in diameter.3.3. Chronic salpingitis was found in one-sixth of the white and more than one-half of the Negro patients with fibromyoma. On the other hand, 40 per cent of all operations for chronic salpingitis revealed complicating fibromyomas.4.4. Necrosis in general was about twice as frequent in the tumors of the Negro women as in those of the white women.5.5. Fibromyomas were found to be relatively free from malignant complications, but sarcomas were more frequent in the Negro, while carcinomas were more common in the white women.6.6. Complicating ovarian changes revealed follicular and corpus luteum cysts to be relatively frequent, cystadenoma to be present in 2 per cent of all fibromyomas, and dermoid cysts in 1 per cent of the white and in 2 per cent of the Negro patients.

Occiput posterior presentation of the fetus since its designation and study as such by Baudelocque, Capuron and Naegele more than a century past has aroused increasing interest among obstetricians. Because of high incidence and poor management it probably has caused more obstetric disorder than any other single condition. Until the introduction of x-ray study of the size and shape of the pelvic cavity early in this century and of the study of the contour of the uterine cavity, only recently begun, all theories in regard to the etiology of occiput posterior presentation were speculation.Occiput posterior presentation may be classified into three categories:Primary occiput posterior presentations occurring at the onset of labor which rotate in labor to occiput anterior presentations.Those which may rotate to cephalic transverse presentations and become stationary, so-called cephalic deep transverse arrests.Those that are delivered as occiput posterior. The etiology of

Many investigators have asserted that they have cultured an organism comparable to the Donovan body on a variety of mediums, particularly Sabouraud's.1 However, the types of organisms cultivated by the various investigators have not been identical. Moreover, subcutaneous inoculation of such organisms into human beings has failed in every instance to reproduce the typical lesions of granuloma inguinale.2 It is therefore doubtful that the etiologic agent of this disease has ever been cultivated. On the other hand we have on several occasions aspirated material from unruptured inguinal abscesses (pseudobuboes) of granuloma inguinale in which the sole micro-organism present was the Donovan body. In attempting to corroborate the observations of previous investigators we met with utter failure to cultivate the Donovan body or any other organism from this material.3 Since a pure culture of Donovan bodies was contained in the aspirated pus, we felt that some light might

Granuloma inguinale, as the name implies, is a granulomatous process which usually occupies the inguinal region. The well known proclivity of the disease for the external genitalia has earned for it a place in the category of venereal diseases. Its venereal origin, however, has never been absolutely proved.The development of granuloma inguinale is not confined to the external genitalia, the vagina, the perineum, the buttocks and the groin. It may occur primarily on the cervix. The recognition of this fact is of utmost importance in the differentiation of carcinoma of the cervix uteri, which it closely simulates.1 Recently there was recorded a case of granuloma inguinale of the uterus, tubes and ovaries.2 EXTRAGENITAL SITES It has long been known that extragenital lesions occur. In 1905 Donovan3 was struck by the granuloma-like appearance of the lesions in the mouth of a boy in a ward. Scrapings

In the literature of the past 30 years there are only brief, infrequent, and contradictory statements regarding anemia as an etiological factor of dystrophic dystocia and/or prolonged labor.

1.1. Malaria complicated pregnancy in this locality during a period of twenty years, once in 727 live white births and once in 2,260 negro livebirths recorded.2.2. With the youngest patient 15 and the oldest 41, three-fourths were under 26 years of age. Two-thirds were in the last trimester of pregnancy. It was more frequent in white women.3.3. The symptoms were mainly those of recurrent high fever and anemia. Most were treated with quinine, and its effect in regard to pregnancy was studied.4.4. The maternal mortality was about 4 per cent; fetal approximately 60 per cent. It seems that an attack of malaria is more fatal to the fetus if occurring early in pregnancy and more dangerous to the mother if occurring late.5.5. The maternal blood of the placenta apparently becomes a store-house for the malarial parasites, but in no case could we find them in the fetal blood.

1.1. Study of the superior strait in 400 negro female pelves by Thoms' grid method revealed more anthropoid and less android types of pelves than occur in the white patients as studied by Caldwell and others.2.2. A device is illustrated (Fig. 2) for simplifying Thoms' grid method so that the superior strait may be viewed and measured from an 8 by 10 inch film and a technician may complete the procedure in ten minutes.3.3. The inlet to the majority of negro female pelves is essentially round in agreement with Thoms' findings in white women.4.4. The operative incidence of the negro women may be less than in the whites partially because of less occurrence of android type of pelves.

A number of reports1 state that the normal pregnant woman has some substance in her blood which will neutralize posterior pituitary injection and that an injection of this substance into preeclamptic patients will occasionally initiate the onset of convulsions. The investigations of Schockaert and Lambillon2 and of Dieckmann and Michel3 demonstrated that approximately 65 per cent of preeclamptic and eclamptic patients show abnormally great and prolonged blood pressure elevations and antidiuretic responses to pitressin. Since the studies of Necheles and Neuwelt4 indicate some antagonism between acetylcholine and pitressin, the question arose whether acetylcholine activity is altered or abnormal in eclamptic toxemia.There are some data which suggest that a relative decreased acetylcholine activity may occur in preeclampsia. Human placentas contain large amounts of acetylcholine, as was shown by Chang and Gaddum,5 who reported 28 micrograms per gram of fresh placenta. Hofbauer6 reported acetylcholine values

Many factors contribute to the presence of pelvic pain during menstruation. Attention in the present paper will be devoted primarily to the myometrium, though the person as a unit must always be considered. The present knowledge concerning human nonpregnant uterine contractions is based on extensive investigations on experimental animals supplemented by careful clinical observations and uterine pressure records from control, pregnant and dysmenorrheal patients. Intrauterine pressure records from the nonpregnant human uterine were first obtained by Moir,1 who observed during menses that contractions occurred every two minutes and developed pressures as high as 100 mm. of mercury. No pain but a feeling of heaviness and discomfort occurred when uterine pressures of 120 mm. of mercury were present. In patients with severe dysmenorrhea, pressures of 150 mm. of mercury were recorded and vascular pulsations disappeared at 120 mm. of mercury. Bickers2 showed that high uterine tone is associated with