Vol 6, No 3 (1892)

Dear Sirs, Dear comrades! Appreciating the sacred customs of our Society and starting today the duties of the Chairman of the Obstetric and Gynecological Society in St. Petersburg for the biennium of 1892-1893, I will begin my activity with an introductory word, which was imputed to us at the founding meeting of 1886, - the duty that our Chairmen have up to now performed unswervingly.

Diagnosis of ectopic pregnancy, especially in the first 2-3 months, is so difficult that many doctors consider it possible in extremely rare cases. Bandl doubts the possibility of diagnosing an ectopic pregnancy up to 3 months, if it is not accompanied by any complications. Professor NF Tolochinov says that "recognition of an ectopic pregnancy in the first half of it is possible only in exceptional cases, under especially favorable circumstances." Professor Krassovskiy claims that the diagnosis of an ectopic pregnancy, especially in the early stages of her pregnancy, can only be made with a certain probability. Spiegelberg, Schröder and many others hold the same view on the diagnosis of ectopic pregnancy, and Depaul considers it almost completely impossible to recognize this anomaly in the first 4-5 months of its development.

The congenital deformity of the uterus duplex separatus occurs, according to Schröder, so rarely that it was more often found on the section table next to such deformities that made the fetus unable to live, and only recently have a number of cases in adult women been published. In my six-year zemstvo practice on 87,000 men and women sick with all diseases in general, it comes across only the second time. Unfortunately, I cannot describe the first case, because the patient, left for a more detailed study, left without being written down even in the book; but both cases are so similar that the thought of the complete identity of the patients involuntarily appears.

71 members were present: Andreev N. Yu., Baykov, Baskin, Batsevich, Brandt, Vasten, Berlinskiy, Volovskiy, Vorobyov, Hermonius, Gess, Goraiskiy, Grinev, Danilovich, Dobradin, Dobrovolskiy V., Dobrovolskiy S., Dranitsyn, Zheltukhin, Zabolotskiy, Zamyatin, Kireev, Krasnopolskiy, Lebedev, Lichkus, Mazurkevich, Martynov, Martsynkevich, Maslovskiy V., Massen, Mersh, Misevich, Ott, Petrov, Shotrovich, Polonskiy, Pootebnov, Popov, Porshnyakov, Radetskiy I., Radektsiy R., Rachinskiy, Renteln, Ruzi, Runge, Rutkovskiy, Savchenko, Sadovskiy, Salmanov, Slavyanskiy, Smolenskiy, Smolskiy, Soloviev A.S., Stravinskiy, Strogonov, Sutugin, Fisher A., ​​Fisher B., Fratkin, Tsekhanovetskiy, Chagin, Chernevskiy, Chernyshev. Shverdlov, Schmidt, Shtol, Stolz, Shurinov. Schuttenbach, Eichfus, Yanpolsky and 10 guests.

E.G. Gurin presented a new explanation of the origin of eclampsia. Of all the existing theories of the origin of eclampsia - Frerichs, Rosenstein-Traube, Halberstma, Stumpf, Blanc - none of them stand up to strict criticism and cannot serve to explain all the varieties of eclamps. Studying the clinical picture of eclampsia, we find in it a great similarity with the picture of violent and severe poisoning and therefore we can put forward a hypothesis about eclampsia, as a disease resulting from a kind of self-clogging of the female body with chemical poisons.

The author, by means of precise studies, stated that lysol from the point of view of killing bacteria is at least equivalent to carbolic acid, being at the same time much less toxic.

At the suggestion of prof. Löhlein's author experimented at the Giessen clinic with Hydrastininum muriaticum. This drug was offered to patients or by mouth in the form of gelatin capsules, the size of a decent pill, containing 0.025 Hydrast. muriat., or under the skin in the form of a sterilized solution containing 0.025-0.1 of this agent. When applying this agent inside or under the skin, the author did not observe any side effects. The functions of the gastrointestinal canal were not disturbed, there were no abscesses at the injection site.

The number of observed miscarriages is 60; 8 of them had a fever (38-41 °) before admission to the author's use, and one patient died 2 hours later after the decomposition of the decomposed ovum (septic peritonitis) was removed from the uterus. The remaining 52 cases gave 3.7% morbidity and 0 mortality.

Having made a brief review of uterine ruptures during pregnancy and childbirth, both voluntary and traumatic, the author describes a case of rupture that was under his supervision, the interest of which is that the rupture occurred spontaneously in the early period of labor, without previous threatening symptoms and ended in recovery with conservative treatment.

Primiparous, 20 years old. Childbirth lasted three days under the supervision of a simple midwife, and then a city grandmother, and only on the 4th day the woman in labor was in the maternity hospital. 6 weeks before giving birth, the pregnant woman fell on the sacrum and was badly hurt — since then she had severe pains in the lower abdomen with severe fever with tremendous chills, which kept her in bed all the time. When examined through the vagina, a tumor is low in the pelvic cavity, round, slightly painful, certainly motionless, dense, filling the entire sacral cavity; the upper border of the tumor is not defined behind the presenting head.

The author gives a case of parametritis puerperalis, complicated by Influenza, which manifested itself as headache, chills, cough, and other symptoms.

In the preface to the report by prof. A.M. Makev describes the history of the origin and realization of the idea of building a new obstetric clinic named after E.V. Paskhalova, who donated large capital for this good cause; The detailed plans attached to the report clearly illustrate the description of this exemplary institution.

During the reporting year, 33 pregnant women and 800 women in labor were admitted to the clinic; 820 were allowed from the burden, 13 were discharged before delivery. In addition, 193 women were denied admission for lack of place. Of the total number of primary-pregnant women admitted to the hospice, 152 (18.2%), second-pregnant — 173 (20.8%), and re-pregnant — 508 (61.0%); at the age of 15 to 20 years — 110, from 21 to 25 years — 270, from 26—30 years —262, from 31—45 years — 191. There were 4 primiparas over 30 years old.

The causes of uretero-vaginal fistulas can be not only various obstetric operations, but also some and gynecological; Among the latter, the first place is occupied by vaginal extirpation of the uterus affected by cancer.

A Jewish woman, 65 years old, has been ill for several days, complains of a fever and pain in the lower abdomen. On 2 transverse fingers under the pubis, a tumor is felt, very painful, emanating from the small pelvis; complete prolapse of the vagina and incomplete uterus; with a double study of the reduction of the fallen out parts, it is determined that the fornices are free, and the above-mentioned painful swelling is a direct continuation of the significantly enlarged uterus.

Without going into either the history of this operation or its literature, the author of the note shares with the reader the impressions that he took from the personal direct observation of the operation in the hands of various gynecologists of our time (Reap, Second, Olshausen, Martin ' a, Leopold''a, H.H. Phenomenova, V.F.Snegirev and D.O. Ott).

The patient complains of a feeling of pulsation in the lower abdomen. When investigated in the left arch is determined by an elastic tumor, spherical, very clearly pulsating; the tumor is placed in the left broad ligament immediately above the fornix, which it protrudes from top to bottom, tightly adjoins the uterus from the place of attachment of the fornix almost to the bottom of the uterus; its size is about a hen's egg, the surface above and below is smooth, a transverse groove runs along the front surface; with prolonged pressure, the tumor decreases by half, with the cessation of pressure, it quickly returns to normal.