Finally, we must class with operative sterility the result of surgical procedure undertaken by gynecologists to save women, whose lives have already been seriously threatened by pregnancy or parturition, from a repetition of this experience. In such cases, Blundell recommends division of the Fallopian tubes, having found from experiments upon rabbits that this is a safe and certain means for the prevention of conception. Frorieps and Kocks have both frequently brought about an artificial sterility in women by closure of the tubes, the first-named by cauterization with nitrate of silver—the caustic being attached to the end of a piece of whalebone and introduced through a canula into the uterine orifice of the Fallopian tube—whilst Kocks has constructed for the same purpose a galvano-caustic uterine sound, which is only rendered red-hot by passage of the current after it has been introduced into the uterine ostium of the tube. Both these methods are in the first place too uncertain to be relied upon for the attainment of the desired end, and in the second place their employment appears to be neither easy, nor free from danger.
As the importance of conservative methods of procedure becomes once more fully recognized in modern gynecology, cases of operative sterility will become ever more and more rare.
TABLE SHOWING THE CAUSES OF STERILITY IN WOMEN.
I. Sterility due to Incapacity for Ovulation.
ABSOLUTE AND IRREMEDIABLE.
Complete absence of the ovaries.
Congenital atrophy of both ovaries.
Premature atrophy of the ovaries, in consequence of infectious disorders, constitutional diseases, and toxic influences.
New-growths of the ovaries, destroying all the follicles.
Senile changes in the ovaries.