Isidor Rubin
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Isidor Clinton Rubin (January 8, 1883 in Germany – July 10, 1958 in London) was an American
gynecologist Gynaecology or gynecology (see spelling differences) is the area of medicine that involves the treatment of women's diseases, especially those of the reproductive organs. It is often paired with the field of obstetrics, forming the combined area ...
who developed the Rubin test, a tubal insufflation test. This is an office procedure to check for
tubal patency The fallopian tubes, also known as uterine tubes, oviducts or salpinges (singular salpinx), are paired tubes in the human female that stretch from the uterus to the ovaries. The fallopian tubes are part of the female reproductive system. In o ...
in the
infertility Infertility is the inability of a person, animal or plant to reproduce by natural means. It is usually not the natural state of a healthy adult, except notably among certain eusocial species (mostly haplodiploid insects). It is the normal state ...
investigation.


Biography

Although Rubin was born in Friedrichshof, a small place in
Prussia Prussia, , Old Prussian: ''Prūsa'' or ''Prūsija'' was a German state on the southeast coast of the Baltic Sea. It formed the German Empire under Prussian rule when it united the German states in 1871. It was ''de facto'' dissolved by an em ...
, he usually told people that he was born in
Vienna en, Viennese , iso_code = AT-9 , registration_plate = W , postal_code_type = Postal code , postal_code = , timezone = CET , utc_offset = +1 , timezone_DST ...
. Rubin's parents were Nehemiah Rubin and his wife Froma, née Keller. He came to America at an early age, was educated at the
City College of New York The City College of the City University of New York (also known as the City College of New York, or simply City College or CCNY) is a public university within the City University of New York (CUNY) system in New York City. Founded in 1847, Cit ...
and received his medical degree from
Columbia University Columbia University (also known as Columbia, and officially as Columbia University in the City of New York) is a private research university in New York City. Established in 1754 as King's College on the grounds of Trinity Church in Manhatt ...
in 1905. He then trained for three years at The Mount Sinai Hospital. In 1909, he went to Vienna to work for one year in Schottländer's laboratory of gynecologic pathology at the II Universität-Frauenklinik. In 1914, the year he married Sylvia Unterberg, he returned to Vienna to study under
Ernst Wertheim Ernst Wertheim (21 February 1864 – 15 February 1920) was an Austrian gynecologist born in Graz. Ernst Wertheim was the son of Theodor Wertheim, an Austrian chemistry professor at the University of Graz, remembered for his chemical studies of ...
. Back in New York, he joined the staff of Mount Sinai Hospital and Beth Israel Hospital. From 1937 to 1948 he was a clinical professor of obstetrics and gynecology at Columbia University. He retired in 1945 from active service at The Mount Sinai Hospital and became a consultant. While attending a conference in London, Rubin died on July 10, 1958.


Tubal insufflation (Rubin test)

Rubin maintained a private practice and was interested in
infertility Infertility is the inability of a person, animal or plant to reproduce by natural means. It is usually not the natural state of a healthy adult, except notably among certain eusocial species (mostly haplodiploid insects). It is the normal state ...
. Realizing that many patients suffered from
tubal obstruction Fallopian tube obstruction, also known as fallopian tube occlusion is a major cause of female infertility. Blocked fallopian tubes are unable to let the ovum and the sperm converge, thus making fertilization impossible. Fallopian tubes are also kno ...
, he developed tubal insufflation as a non-operative method to evaluate the tubes. The instrument is based on the principle that under a certain pressure, gas can be pushed via the cervix and uterus through the tubes into the abdominal cavity where its presence can be detected by distension and other means. In cases of nonpatency increasing pressure is exerted until a threshold level is reached. For his first experiments in 1919 he used
oxygen Oxygen is the chemical element with the symbol O and atomic number 8. It is a member of the chalcogen group in the periodic table, a highly reactive nonmetal, and an oxidizing agent that readily forms oxides with most elements as wel ...
, later he switched to
carbon dioxide Carbon dioxide (chemical formula ) is a chemical compound made up of molecules that each have one carbon atom covalently double bonded to two oxygen atoms. It is found in the gas state at room temperature. In the air, carbon dioxide is transpar ...
as this insufflation medium is quickly absorbed, less painful and safer. His instrument and technique were later supplemented with a
kymograph A kymograph (from Greek κῦμα, swell or wave + γραφή, writing; also called a kymographion) is an analog device that draws a graphical representation of spatial position over time in which a spatial axis represents time. It basically consi ...
to record the pressure readings. The Rubin test became a standard test to check the tubes in the investigation of causes of infertility and was claimed to be able to open up tubes in some patients with tubal occlusion. In 1958, Speert stated that "many gynecologists regard it as the twentieth century's most important contribution to the clinical study of female infertility." However, with the advancement of other techniques, notably laparoscopy, within the next two decades, the Rubin test lost its importance and it is not mentioned in contemporary textbooks.


Other contributions

Among other contributions to gynecology were his observations regarding the early development of
cervical cancer Cervical cancer is a cancer arising from the cervix. It is due to the abnormal growth of cells that have the ability to invade or spread to other parts of the body. Early on, typically no symptoms are seen. Later symptoms may include abnormal ...
. He was one of the first to use hysterosalpingography in the diagnosis of tubal and uterine disorders. His studies on
ectopic pregnancy Ectopic pregnancy is a complication of pregnancy in which the embryo attaches outside the uterus. Signs and symptoms classically include abdominal pain and vaginal bleeding, but fewer than 50 percent of affected women have both of these symptoms. ...
laid down the principles to identify a cervical pregnancy that became known as Rubin's criteria.


Books

* Rubin IC. Uterotubal Insufflation. CV Mosby Co, St. Louis, 1947. * Rubin IC. Symptoms in Gynecology, 1923. * Rubin IC, Novak J. Integrated Gynecology, McGraw-Hill, New York, 1956.


Awards

* In 1947, a special issue of the ''Journal of the Mount Sinai Hospital'' was dedicated to Rubin at the occasion of the 25th anniversary of the Rubin test. * In 1957, a special issue of
Fertility and Sterility The American Society for Reproductive Medicine (ASRM) is a nonprofit, multidisciplinary organization for advancement of the science and practice of reproductive medicine. The society has its headquarters in Washington, D.C and its administrati ...
– Volume 8, number 6 – commemorated his 75th birthday. * Among the many honors Rubin received is the title of officer of the French
Legion of Honour The National Order of the Legion of Honour (french: Ordre national de la Légion d'honneur), formerly the Royal Order of the Legion of Honour ('), is the highest French order of merit, both military and civil. Established in 1802 by Napoleon, ...
.


References

{{DEFAULTSORT:Rubin, Isidor Clinton 1883 births 1958 deaths American gynecologists Officiers of the Légion d'honneur German emigrants to the United States