Vol 6, No 1 (1892)

Congenital anomalies of the female genital organs are, in addition to their clinical interest, also anatomical interest, serving to a known extent as a touchstone for checking the history of the development of the genital apparatus that we have. Some anomalies in the area of ​​external genital organs have given rise to new embryological studies in recent years, which gave valuable data concerning the history of the development of the ano-genital area. The same data serve for a better understanding of the way of origin of some anomalies, among other things also anomalies, known as atresiae ani vestibularis, vulvaris, hymenalis, or better anus praeternaturalis vestibularis.

On September 7, 1891, A. Ya. Krassovsky was placed in the pregnant ward for the production of artificial premature births, a pregnant woman in the 3rd section, the widow of a soldier Fyokla Petrov, 35 years old, a native of the Yaroslavl province, on which he had already performed an operation with Kochen 1886 year.

32 members attended.

In 1859 (? Is it a typo?) The author had to accept a baby, normally built with the exception of the following rare anomaly: the baby was born as if sitting astride a ball. Anus is missing; the sac, formed by the continuation of the fetal skin, occupies the buttocks and the back of the thighs to the scrotum and goes down to the middle of the legs. The skin that forms the membrane of this sac is of normal thickness and bluish-reddish color, depending on the bloody-serum contents of the bag and on the abundantly developed veins.

Protracted the 1st birth with the head end. The bladder is very distended with urine, which could not be released, since the squeezed urethra did not pass the catheter. True conjugate 81/2 s. (the author does not mention how the true conjugate was determined neither in this nor in the following cases, ref.). The child is dead. A dead macerated boy with pronounced traces of forceps on his head was removed by very energetic traction. "Postpartum course with mild fever and pain in the lower abdomen, but the postpartum woman recovered after 3 weeks."

A more detailed study of this issue will be included in the author's dissertation, and now, on the basis of the literary material he cites, as well as on the basis of his own employment in the clinic of prof. A.I. Lebedeva puts the following six provisions

Mrs. F. 44 years old, 25 years old married; two miscarriages and 6 normal births, the last birth in August 1884. Amenorreya from January 1890 to August inclusive. In July, within two weeks, watery discharge from the genital tract. Over the past months, the breasts have swollen, but in August they fell off again. Severe at times abdominal pains stopped along with the cessation of fetal movements. In September, mild fever. When investigated, an asymmetric semi-dense tumor is found in the abdomen.

Is there surgery or palliative care in the treatment of ectopic pregnancy? This is the question that the author asks himself and to which he answers in favor of surgical intervention.

So widely used in the recent past, small gynecological operations in our time, the time of large operations, are more and more losing their meaning. The author explains this mainly by the fact that our diagnostic tools have recently increased and improved significantly. We know something that was not known to our predecessors, namely that not all so-called uterine diseases have the starting point of the uterus itself, or that uterine disease is only secondary. Thanks to the success of diagnostics, we are relieved of many not only unnecessary, but often dangerous for patients manipulations in the uterus, which were previously considered inevitable.

The author distinguishes between mediocre and direct methods: the first ones include: 1) stitching of perineal ruptures, operations during the prolapse and prolapse of the vagina and uterus; 2) suturing of deep ruptures of the neck; 3) wedge-shaped excision and amputation of the neck; 4) Removal of tumors that displace the uterus posteriorly by means of celiac disease; 5) Castration. - There are a large number of direct methods.

Proceeding from the opinion that any method of treatment leading to a decrease in severe suffering or to a cure of uterine fibroids should be published, the author reports from his practice 3 cases of uterine fibroids treated by him with ergotine injections into the tumor tissue

Mrs. M. R. H. 44 years old, widow, mother of three children; enjoyed excellent health until the first birth, 24 years ago. Since then, she began to complain of pain in the uterus and in the ovaries. After suffering typhoid fever 8 years ago, the pain intensified and spread to the entire abdomen and lower back. Having examined her at different times, four doctors consistently found the following: cervical rupture; endocervicitis; swelling in the left side of the abdomen; fibroma. Finally, in one of the hospitals, a malignant tumor associated with the liver (?) Was diagnosed. The mass that had fallen out of the vagina in this American hospital could not be corrected and was limited to light laxatives.

This article presents an extremely short report on 11 laparotomies produced by the author over the past two years. For eleven of these operations, one was fatal. The author presented his 11 cases in the table, from which we borrow only two columns - illness and surgery.

London. Having visited German and French gynecologists, everywhere I met more or less strict adherence to asepsis and antiseptics during operations, only in England there are, however, only two gynecologists who decided to stop the use of antiseptics in their operative practice and postoperative results are not only no worse, but even better. The operators are Lawson Tait (in Birmingham) and Bantock (in London). Interested to see personally the production of operations without antiseptics, I decided to visit Bantock's clinic.