. The diagnosis of diseases of women . eatening life, and those causingmore or less invalidism. Of the fatal degenerations and complica-tions there were 88. Of complications threatening the life of thepatient there were 37, and of conditions leading to more or lessinvalidism there were 43, thus giving a sum total of 168 seriouscomplications in 258 cases of uterine fibroids. Noble presents therecords of four surgeons, including himself, and estimates that of688 cases of uterine fibroids the presumptive mortality withoutoperation from the degenerations and complications of the tumorsand changes
. The diagnosis of diseases of women . eatening life, and those causingmore or less invalidism. Of the fatal degenerations and complica-tions there were 88. Of complications threatening the life of thepatient there were 37, and of conditions leading to more or lessinvalidism there were 43, thus giving a sum total of 168 seriouscomplications in 258 cases of uterine fibroids. Noble presents therecords of four surgeons, including himself, and estimates that of688 cases of uterine fibroids the presumptive mortality withoutoperation from the degenerations and complications of the tumorsand changes taking place in the uterus itself varied as follows: Martin .......... 16 per cent. Noble 16 Frederick 23 Cullingworth 24 Average DIAGNOSIS OF FIBBOMYOMA OF THE UTERUS 321 Adding the complications met with outside the uterus the mor-taUty would reach about 45 per cent. Noble concludes that one-fourth the cases would result in chronic invalidism and one-thirdin death if no operation is performed. Noble says: *^It seems a Fig. 139. Fibrous polyp of the cervix. The uterus shows senile atrophy together with three smallsubperitoneal fibroids. The polyp is of unusual size. Such polypoid growths are proneto arise in a senile uterus. They are frequently the cause of hemorrhage in the post-climacteric period. fair conclusion that the resort to early operation will effect a savingof 25 to 30 per cent, in mortality in addition to the perhaps greatersaving in the mortality which follows operation as compared withthat which is incident to the history of fibroid tumors. Thestatistics of Noble, Frederick, Martin, and Cullingworth impress 21 322 SPECIAL DIAGNOSIS us with the fact that fibroids of the uterus are by no means theinnocent tumors that former writers would have us beheve. The various forms of degeneration of fibroids are not only ofpathological interest, but their recognition is of the greatest clinicalimportance. Noble estimates that serious complications arise in fibroids in
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