Speculum - University of Melbourne

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48 SPECULUM ReJearch . . . ". . . . to merit and preserve the confidence of the best element in the medical and pharmaceutical professions . . . . to build well, to last." It was in these words that, over 90 years ago, the founders of the House of Parke-Davis expressed their policy for the future. To meet these self-imposed and exacting demands, research has been a constant feature of the Company's activities. Over the years many contributions to Medicine have resulted: vegetable drugs such as Cascara Sagrada; glandular products, including Adrenalin, Pituitrin, Pitocin, Pitressin, Antuitrin "S" and Eschatin; vitamin preparations; and many synthetic chemicals such as Dilantin. Recent achievements include the antihistamines, Benadryl and Ambodryl, and the first synthetic antibiotic, Chloromycetin. Today, backed by a research programme more extensive than ever before, Parke-Davis offer the medical profession products worthy of their symbol, "Medicamenta Vera"—truth in medicine. PARKE, DAVIS & CO., LTD. (Lnc. BOX 4198, SYDNEY
SPECULUM 49 Post-coital douching has often been suggested, but as douching only washes out the sperm in the vagina, it is not very effective against the motile sperm already within the cervix and uterus. Some authorities believe that at the moment when the female reaches her orgasm there is a movement of the uterine muscle wall which, by suction, facilitates the entry of the sperm into the uterus. If this theory is correct, then post-coital douching is akin to closing the stable door after the horse has vanished. This theory also casts grave doubt on the usefulness of the intra-cervical stem, or "collar stud", which is supposed to plug up the canal against sperm entry, not that these were ever considered useful because the dilation of the cervix can vary greatly. Because of this constant variation in the muscular cervix, cervical caps, which are also supposed to prevent sperm entry, are of little use. Intra-uterine rings have found widespread usage. These were accidently developed by Dr. Grafenberg when he was carrying out experiments in an attempt to increase fertility. They should be inserted only by an experienced medical practitioner. The cervix is dilated and the ring is inserted into the uterine cavity. Not much is known about the theory of their action but it is probably mechanical, or, perhaps a response of the uterus to the foreign object, because it is equally effective no matter from what material it is made. Although pregnancy has occurred in some cases when a Grafenberg ring was present in the uterus, it is considered to attain a high percentage of reliability. Certain authorities do not approve of them on the grounds that the intra-uterine presence of a foreign body may enhance the possibility of local cancer. Whilst this may be so, I have yet to hear of a case of oral cancer which is blamed on the presence of false teeth. Smith-Petersen metallic pins in the neck of the femur and medullary pins in the same bone do not bring about an increase in chances of obtaining cancer. Neurosurgeons sometimes insert plates of metal in the bones of the skull without expecting cancer to occur. I am not defending this contraceptive device, but only suggesting a few obvious analogies. On the other hand, the inserting of these rings often results in a temporary upset in the menstrual cycle. It has been suggested that the presence of these rings in the uterus does not interfere with fertilisation, but with the actual implantation of the fertilised ovum in the uterine wall. Local surgical suppliers sell thousands of these rings annually. As they must be inserted by a medical practitioner, and replaced within a specified time, which varies greatly, practitioners who specialise in this are never paupers. It is quite understandable that they appeal to the public, for once they are inserted they can be forgotten for at least 8-12 months, and there is absolutely no interference with intercourse. There is no laborious pre-coital preparation, either, which always has a tendency to inhibit orgasm. Another mechanical device which finds great usage is the occlusive pessary. This consists of a loose circular latex diaphragm attached by its circumference to a circular spring. The latex entirely encloses the spring. It is inserted into the vagina and covers the opening of the cervix. When of the correct diameter it extends from the posterior fornix and rests on the back of the pubic bone. As the spring resists distortion, it is continually in close relation to the walls of the vagina all around its circumference, and hence, to an extent, stops the passage of sperm between it and the vaginal wall reaching the cervix. One firm markets diaphragms in sizes from 55 mm to 90 mm. in gradations of 5 mm. The particular size is decided by the physician using a set of fitting rings. The appropriate sized diaphragm is obtained and the patient then attempts to fit it herself, with the doctor's assistance. She inserts it by compressing the ring with the fingers and positioning it whilst in a reclining position. She pushes it well back until it is felt to cover the cervix, and then the anterior part is forced upwards behind the pubic bone. The manufacturer states that if the patient or her husband is conscious of its presence, then it is of incorrect size. When the patient is unable to insert it in this manner, perhaps because of short fingers or a long vagina, a plastic introducer can be obtained. The diaphragm is placed on the introducer which extends it along one diameter and hence decreases its width. It is
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Page 4 and 5: 2 SPECULUM WHAT IS LIFE ASSURANCE ?
Page 6: SPECULUMik Contents \NE ER ITy 0 LI
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Page 11 and 12: SPECULUM 9 Editorial:— Cancer : W
Page 13 and 14: SPECULUM 11 Meet PROFESSOR MAURICE
Page 15 and 16: SPECULUM 13 thoracic surgery which
Page 17 and 18: SPECULUM 15 E.C.G. DIAGNOSIS OF CON
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Page 21 and 22: SPECULUM 19 Fig. 11—Tracing from
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Page 27 and 28: SPECULUM 25 PRE-ANAESTHETIC MEDICAT
Page 29 and 30: SPECULUM 27 b. Central Nervous Syst
Page 31 and 32: • SPECULUM 29 MEDICAL EDUCATION K
Page 33 and 34: SPECULUM 31 Medical Journal accused
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Page 37 and 38: SPECULUM 35 it seemed to the medica
Page 39 and 40: SPECULUM 37 pressed by the methods
Page 41 and 42: SPECULUM 39 INFAMOUS CONDUCT IN A P
Page 43 and 44: SPECULUM 41 in a professional respe
Page 45 and 46: SPECULUM 43 LIFE OF EUSTACE LOVELAC
Page 47 and 48: SPECULUM 45 volume, vessel impalpab
Page 49: SPECULUM 47 SOME CONTRACEPTIVE TECH
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Page 55 and 56: SPECULUM 53 BOOK REVIEWS RADIOLOGIC
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Page 61 and 62: SPECULUM 59 FILM: "People who aren'
Page 63 and 64: SPECULUM 6t SURGERY Professor Ewing
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Page 67 and 68: SPECULUM 65 MI-1,DICAL Alf,DLI -;rY
Page 69 and 70: SPECULUM 67 ANSWERS TO DIAGNOSTIC Q
Page 71 and 72: SPECULUM 69 Int.BYtant M. S. S. CHR
Page 73 and 74: SPECULUM 71 ANNUAL DINNER JUNE 13th
Page 75 and 76: SPECULUM 73 MEDLLY'S '57 Dear S. &
Page 77 and 78: SPECULUM 75 The Stately Homes of Ca
Page 79 and 80: SPECULUM 77 PRE-MEDICINE This year
Page 81 and 82: SPECULUM 79 play as they had to swo
Page 83 and 84: SPECULUM 81 ROYAL MELBOURNE HOSPITA
Page 85 and 86: SPECULUM 83 ALFRED HOSPITAL THIRD Y
Page 87 and 88: SPECULUM 85 THIRD YEAR ST. VINCENT'
Page 89 and 90: SPECULUM 87 PRINCE HENRY'S HOSPITAL
Page 91 and 92: SPECULUM 89 spicula Surgeon, to pat
Page 93 and 94: SPECULUM 91 Gallup pole clerk visit
Page 95 and 96: SPECULUM 93 After a man finds out t
Page 97 and 98: SPECULUM 95 e y Girl's voice heard
Page 99 and 100: SPECULUM 97 Is it true that storks
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SPECULUM 99 What would you do if a
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