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The concept that hysterectomy is of value in the management of septic abortion induced by instillation of soap or phenolic antiseptics into the uterus is challenged. Nineteen out of 20 such cases with renal failure were managed with intensive antibiotic therapy, peritoneal dialysis and an absolute minimun of surgical intervention. Seventeen patients recovered, with normal renal function. Of the 11 known to be subsequently exposed to conception seven have achieved normal pregnancies.

Clostridium perftingens (Cl. welchii) infection following an abortion has always been associated with a very high mortality, often as great as 80% (Toombs and Michaelson, 1928 ;Hill, 1936;Russell and Roach, 1939; Butler, 1945). Although the use of antibiotics in addition to antitoxin might have been expected to reduce the death rate, the fatality rate recorded by Mahn and Dantuono (1955) differed little from that of previous reports. Immediate hysterectomy (Decker and Hall, 1966), hyperbaric oxygen (Brummelkamp et al., 1963 i McAllister et al., 1963Brummelkamp, 1965), and exchange transfusion (Bessis, 1949 ;Funck-Brentano et al., 1965) (1951). Fibrinogen catabolism was measured, using fibrinogen prepared by the method of Regoeczi and Walton (1967) and iodinated by the 13"I monochloride method of McFarlane (1963). The fractional catabolic rates of fibrinogen and the relative partition of the protein between the intravascular and the extravascular compartments were calculated by the method of Matthews (1957).Fibrin split products were assayed in the serum by agar-gel immunodiffusion (Ouchterlony, 1958) and by the tanned-redcell haemagglutination inhibition assay, using rabbit anti-human fibrinogen antiserum (Merskey et al., 1966 (Fig. 1).

Summary: Total white cell, neutrophil, and lymphocyte counts were compared in patients with chronic renal failure treated successively by conservative means (lowprotein diet), regular haemodialysis, and renal allotransplantation. The lowest total white cell and neutrophil counts and the highest lymphocyte counts were found in patients on regular haemodialysis. A rapid fall in neutrophil count during the first half-hour of dialysis and a more gradual fall between the first and sixth hours were observed. Adherence of neutrophils and mononuclear cells to the cuprophane (PT 150) dialysis membrane has been shown.

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