Vol 6, No 4 (1892)

Various kinds of diseases, known under the common name of childbirth fever, are caused by the penetration of pathogenic microbes into the genitals during childbirth, the postpartum period, and even sometimes during pregnancy. The main place of introduction of microbes is the inner wounded surface of the uterus, and then all sorts of superficial and deep damage to the genital canal, due to the most generic act. In view of this, according to the existing view, especially in Germany, the diseases that now occupy us are the essence of infectious diseases of wounds emanating from the genital area. According to the influence of microbes, the course and partly the influence of therapeutic measures, postpartum diseases are divided into: 1) septic diseases in the broad sense of the word, caused by the introduction of pathogenic microbes into living tissue and 2) putrefactive poisoning, which occurs from the blood metabolism of micronutrients in the beginning - Saprämia (Duncan), There are pure cases of both forms; but much more often it is difficult to separate one form from another. —The method of infection that complicates ordinary wounds is not thought at all, being content only with the definition of it, in full conviction that it, as it were not transmitted to the wound, always occurs from the outside. In obstetrics, in relation to the way of infection, the case seems to be more complicated and confusing; as there is a special type of infection known as "self-infection"

One of the most interesting and important questions of operative gynecology was and is the question of surgical methods of treatment of uterine cancer. The task and purpose of each operative removal of a malignant neoplasm should be expressed, on the one hand, in its technical simplicity, and, on the other, in achieving the desired and final result, i.e., in the radical healing of the body, since the operation is undertaken under conditions with a predicted quo ad valetudinem, and not quo ad vitam. A whole galaxy of scientists, converging more or less in this complex and main goal of surgical intervention for uterine cancer, begins to break up into groups, as soon as it comes to the nature and extent of the spread of neoplasm in connection with the operative method, with indications and contraindications to it. These disagreements, depending both on the difficulty of determining in each given case microscopically the extent of cancer prevalence, and on the complexity of some of the problems, are the reason that the main surgical methods, such as: Amputatio infravaginalis colli uteri, supravaginalis, colpohysteroectomoectomia and laparohyster serve as controversial points in gynecology.

42 members were present: Andreev N. Yu., Batsevich, Bidder, Vorobyev, Hermonius, Goraiskiy, Danilovich, Dobradin, Dobrovolskiy, Dranitsyn, Dobrovolskiy V.N., Zamshin, Zachek, Lapin, Krasnopolskiy, Lichkus, Maslovskiy V.F., Massen, Mazurkevich, Neishtube, Ott, Popov, Porshnyakov, Radetskiy R.K., Rodzevich, Bachinskiy, Savchenko, Stelmakhovpch, Stravinskiy, Strogonov, Tarnovskiy, Urvich, Fisher A.R., Tsekhanovetskiy, Tsyrskiy, Shverdlov, Schmidt, Shtol, Stolts, Schuttenbach, Eberman, Yanpolskiy and 17 guests.

Prof. V. Ye. Chernov read and distributed printed copies of the "report of the commission, elected by the Obstetrician-Gynecological Society in Kiev to develop the issue of measures to support childless children and foundlings in the South-West Territory". This question was submitted for discussion by the head of the region, Count A.P. Ignatiev. Having examined this issue comprehensively, the commission spoke in favor of the need to establish "hospitals for babies" at least in provincial cities, and, if necessary, in more populated areas of the region, and developed rules for these benefits, when compiling which were guided by the current rules for the admission of children to the IMPERIAL Foster homes and return from them.

Bröse demonstrated a new vaginal electrode that he made for such electrical applications where one wishes to take advantage of the pole-to-pole current. The electrode consists of a clay cylinder with a circumference of 9 cm, which is inserted into the vagina in exactly the same way as a tubular mirror. In this clay cylinder is placed a metal cylinder, equipped with numerous holes, which has a screw at its outer end to strengthen the conductor. After the introduction of the clay cylinder, a metal cylinder is inserted into the vagina, and the clay tube is filled with warm water. The wet clay cylinder is an excellent conductor of current and replaces the skin electrode made from a sponge. If this cylinder is inserted into the vagina for a length of 8-10 cm, then with a circumference of 9 cm, it will correspond to a flat electrode of 72-90 sq. Cm. This electrode is intended for use where one wants to concentrate the current density in more than one place of the vagina. but evenly distribute the current over the pelvic organs. It is used more where, when using strong galvanic currents, they want to avoid the cauterizing effect on the vaginal mucosa, which easily occurs when spherical electrodes are used, despite being wrapped in cotton wool. Finally, it is used where one wants to obtain an interpolar (so-called catalytic) effect. The patient, when using this electrode, tolerates perfectly well currents of 80-100 MA, while cauterization of the vaginal mucosa is not obtained.

The obstetricians are increasingly becoming convinced, based on experience, that in cases where there is a choice between forceps and twist, forceps should be preferred, as it is less dangerous for the mother and the fetus, even in the presence of deformity or narrowness. pelvis. In general, thanks to the advances in instrumental technology and the increasing experience of obstetricians, we can now apply forceps in many such cases in which we did not dare to do so before.

Primiparous 28 years old, urgent labor lasts two days. In childhood, rickets. The child is alive; the throat is opened to the value of a silver ruble; the bubble is intact, tense, the head is presented, driven into the entrance; the transverse dimension of the head coincides with the transverse dimension of the entrance to the pelvis. The size of the pelvis: Dist Spin — 24 ctm .; Dist. Crist, 22 1/2 ; Dist. trochanterica — 23, conjugata externaly 15 1/2 ctm. conj.; diagonalis - 7 1/2 - 8 ctm .; vera— 5 1/2 — 6 ctm. T ° 38.8 °; R. = 88.

In view of the rarity of late postpartum eclampsia, the author considers it not uninteresting to report a case where he had to observe seizures of eclampsia on the eighth day after childbirth.

The author warmly praises local anesthesia with cocaine in some gynecological operations.

The author gives two interesting observations on the installation of menstruation in young girls.

The author enriches 34 cases of surgical treatment of atresiae hymenalis collected by him in the literature with two new ones: one from his own practice and one (unpublished) case from the practice of a friend. The author's way of operating will be clear from the advice he gives at the end of his article.

Trapped several times on a platinum needle, particles of gonorrhea pus from the urethra or from the contents of the tubes with ascending gonorrhea are thoroughly loosened in liquid human blood serum and then prepared from the latter two dilutions according to a known method. Tubes with seeded particles are placed in a water bath at 40 ° C, and their contents are mixed with approximately equal volume of diluted agar (20% agar, 1% peptone, 0.5% NaCl) and poured onto a plate. The plates are placed in a humid chamber and placed in a thermostat at 36-37 °C.

Under the non-surgical method of treatment of uterine cancer, the author means scraping with a spoon with sequential cauterization. Without sometimes denying the need for a radical operation, that is, excision of the cervix or the entire uterus, the author believes that in many cases this dangerous operation, which gives a significant percentage of mortality, can be successfully replaced with curettage, especially in cases where the patient resists the operation, or this the latter is dangerous due to the age and emaciation of the patient.

The author cites from his own observation 2 cases, where under the influence of direct current the birth of submucous fibroids occurred, due to which their prompt removal became possible.

The mechanical method of treatment of prolapses and displacements of the uterus from behind in most cases does not give complete healing.

This article presents a very short report on 10 laparotomies produced by the author on various occasions.