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1092 AMERICAN JOURNAL OP OB~'l'E'fRIGS A~D flYNECOLOOY with the least amount of shock is indicated. Three contraindications to the performance of ...

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1092

AMERICAN JOURNAL OP

OB~'l'E'fRIGS A~D

flYNECOLOOY

with the least amount of shock is indicated. Three contraindications to the performance of craniotomy are also indications for abdominal delivery: (1) a true conjugate of less than 5.5 em.; (2) tumor blorking the pelvis; (3) a fibrous or carcinomatous cervix. A patient who lms had one craniotomy should subsequently be delivered in some place where better obstetric facilities are available. In a ten-year period, during which there were 12,292 deliveries, 29 craniotomies were performed, an incidence of 0.235 per cent. Of these, 12 of the patients had received prenatal supervision in the hospital clinie, and 17 patients were referred from elsewhere. The specific indications for the craniotomies in the series numben;~d ten. Twenty-four of the infants were dead when the operation was performed; 4 babies were hydrocephalic. The duration of the longest labor was approximately 98 hours. In the majority of instances there was a history of membranes having been ruptured for many hours; the longest periods were 178 hours and 144 hours. There were 7 maternal deaths, a mortality rate of 24.1 per cent. Six of the deaths occurred in nonclinic patients, and in 5 of them there were vaginal examina· tions with attempts at delivery in the home. The patients were in poor or critical (\ondition when the operation was performed, and, witlt the single exception of a patient whose pregnancy was interrupted at five months for medical indications, they had been in labor from 40 to 74 hours. The one clinic patient had a hydrocephalic baby; she was examinee! vaginally in the hospital and had a bag induction of labor. There was no autopsy and death was ascribed to •'mholism or ;;:urgical shock. c\I:NOLD GOLDBE!WE,R.

Item Postgraduate Course The Illinois State Department of Public Health and the Chihlren 's Bureau, U. S. Department of Labor are sponsoring ten four weeks' courses in obstetrics at the Chicago Lying-in Hospital during the fiscal year J 941-1942. Only a limited number of physicians will be accepted for each eoursl'. The only cost to the individual is for room and board and $25.00 ($10.00 of whieh is refunded at the eompletion of the course). Applkations and inquirit>!< ~hould he :uldn'Rfit'
Books Received HOLT'S DISEASES OF INFANCY AND CHILDHOOD. By the late L. Emmett Holt and John HoWland. Revised by L. Emmett Holt, Jr., M.D., Associate Professor of Pediatrics, Johns Hopkins University, etc., and Rustin 1-feIntosh, M.D., Carpentier Professor of Pediatrics, Columbia University, New York, etc. Eleventh edition, 262 figures, 1421 pages. D. Appleton-Century Company, New York, 1940. THE MERCK MANUAL. 'l'herapeuties and Materia Medica. Seventh edition, 1436 pages. Merck & Co., Inc., Rahway, N . .T., 1940. MACLEOD'S PHYSIOLOGY IN MODERN MEDICINE. Edited by Philip Bard, Professor of Physiology, .Johns Hopkins University School of Medicine. Ninth edition, 387 :figures, 1256 pages. 'l'he C. V ..Mosby Co., St. Louis, 1941. MODERN DRUG ENCYCLOPEDIA. 'l'herapeutic Guide. By :Jacob Gutman, M.D., Phar.D., :F'.A.C.P., Director, Brooklyn Diagnostic Institute, etc. Secouil editionfl644 pages. Published l1y New Modem Drugs, New York City, 1941. A FAMILY DOCTOR'S NOTEBOOK. By I. J". Wolf, M.D., Professor of :\ie(li·