Isidor Clinton Rubin
Encyclopedia
Isidor Clinton Rubin was an American gynecologist who developed the Rubin test, a tubal insufflation
test. This is an office procedure to check for tubal patency
in the infertility
investigation.
, he usually told people that he was born in Vienna
. 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
and received his medical degree from Columbia University
in 1905. He then worked for three years at 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
. 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 Mount Sinai Hospital and became a consultant. While attending a conference in London, Rubin died on July 10, 1958.
. Realizing that many patients suffered from tubal obstruction, 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
, later he switched to carbon dioxide
as this insufflation medium is quickly absorbed, less painful and safer. His instrument and technique were later supplemented with a kymograph
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.
. He was one of the first to use hysterosalpingography
in the diagnosis of tubal and uterine disorders. His studies on ectopic pregnancy
laid down the principles to identify a cervical pregnancy
that became known as Rubin’s criteria.
Insufflation (medicine)
Insufflation is the practice of inhaling a substance. Insufflation has limited medical use, but is a common route of administration with many respiratory drugs used to treat conditions in the lungs and paranasal sinus .The technique is common for many recreational drugs and is also used for some...
test. This is an office procedure to check for tubal patency
Fallopian tube
The Fallopian tubes, also known as oviducts, uterine tubes, and salpinges are two very fine tubes lined with ciliated epithelia, leading from the ovaries of female mammals into the uterus, via the utero-tubal junction...
in the infertility
Infertility
Infertility primarily refers to the biological inability of a person to contribute to conception. Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term...
investigation.
Biography
Although Rubin was born in Friedrichshof, a small place in PrussiaPrussia
Prussia was a German kingdom and historic state originating out of the Duchy of Prussia and the Margraviate of Brandenburg. For centuries, the House of Hohenzollern ruled Prussia, successfully expanding its size by way of an unusually well-organized and effective army. Prussia shaped the history...
, he usually told people that he was born in Vienna
Vienna
Vienna is the capital and largest city of the Republic of Austria and one of the nine states of Austria. Vienna is Austria's primary city, with a population of about 1.723 million , and is by far the largest city in Austria, as well as its cultural, economic, and political centre...
. 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
City College of New York
The City College of the City University of New York is a senior college of the City University of New York , in New York City. It is also the oldest of the City University's twenty-three institutions of higher learning...
and received his medical degree from Columbia University
Columbia University
Columbia University in the City of New York is a private, Ivy League university in Manhattan, New York City. Columbia is the oldest institution of higher learning in the state of New York, the fifth oldest in the United States, and one of the country's nine Colonial Colleges founded before the...
in 1905. He then worked for three years at 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
Ernst Wertheim was an Austrian gynecologist who was born in Graz. In 1888 he received his doctorate from the University of Graz, and subsequently became an assistant in the department of general and experimental pathology...
. Back in New York, he joined the staff of Mount Sinai Hospital
Mount Sinai Hospital, New York
Mount Sinai Hospital, founded in 1852, is one of the oldest and largest teaching hospitals in the United States. In 2011-2012, Mount Sinai Hospital was ranked as one of America's best hospitals by U.S...
and Beth Israel Hospital
Beth Israel Medical Center
Beth Israel Medical Center is a 1,368-bed, full-service tertiary teaching hospital in New York City. Originally dedicated to serving immigrant Jews living in the tenement slums of the Lower East Side, it was founded at the turn of the 20th century. The main hospital location is the Petrie...
. From 1937 to 1948 he was a clinical professor of obstetrics and gynecology at Columbia University. He retired in 1945 from active service at 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 infertilityInfertility
Infertility primarily refers to the biological inability of a person to contribute to conception. Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term...
. Realizing that many patients suffered from tubal obstruction, 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
Oxygen is the element with atomic number 8 and represented by the symbol O. Its name derives from the Greek roots ὀξύς and -γενής , because at the time of naming, it was mistakenly thought that all acids required oxygen in their composition...
, later he switched to carbon dioxide
Carbon dioxide
Carbon dioxide is a naturally occurring chemical compound composed of two oxygen atoms covalently bonded to a single carbon atom...
as this insufflation medium is quickly absorbed, less painful and safer. His instrument and technique were later supplemented with a kymograph
Kymograph
A kymograph is a device that gives a graphical representation of spatial position over time in which a spatial axis represents time...
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
Laparoscopy
Laparoscopy is an operation performed in the abdomen or pelvis through small incisions with the aid of a camera...
, 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 cancerCervical cancer
Cervical cancer is malignant neoplasm of the cervix uteri or cervical area. One of the most common symptoms is abnormal vaginal bleeding, but in some cases there may be no obvious symptoms until the cancer is in its advanced stages...
. He was one of the first to use hysterosalpingography
Hysterosalpingography
Hysterosalpingography is a radiologic procedure to investigate the shape of the uterine cavity and the shape and patency of the fallopian tubes. It entails the injection of a radio-opaque material into the cervical canal and usually fluoroscopy with image intensification...
in the diagnosis of tubal and uterine disorders. His studies on ectopic pregnancy
Ectopic pregnancy
An ectopic pregnancy, or eccysis , is a complication of pregnancy in which the embryo implants outside the uterine cavity. With rare exceptions, ectopic pregnancies are not viable. Furthermore, they are dangerous for the parent, since internal haemorrhage is a life threatening complication...
laid down the principles to identify a cervical pregnancy
Cervical pregnancy
Cervical pregnancy refers to an ectopic pregnancy that has implanted in the uterine endocervix. Such a pregnancy typically aborts within the first trimester, however, if it is implanted closer to the uterine cavity - a so-called cervico-isthmic pregnancy - it may continue longer...
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 Gyencology, 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 – 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.