Vol 6, No 12 (1892)

Not without some embarrassment, I begin to present the stories of the nine gluttonies I performed in Siberia - this is for the reason that I have to make my message in society, many members of which have long passed between the hundredth ovaryotomy and forever immortalized their name, linking it with in one way or another operative way, generally with the history of chavosexual in our country. But my cases, if they are not of particular interest for a specialist, a gynecologist-surgeon, then, I hope, they will be presented as such for those doctors who, like me for 6 years, every day, by force of necessity, are forced to provide medical assistance to all who turn to them sick, whatever diseases they may be obsessed with.

Communications of various parts of the intestine with the genital area are relatively rare phenomena in gynecological practice; in any case, they are less common than urinary fistulas, which is understandable in view of the anatomical features of the pelvis. Infrequently and descriptions of individual cases of these fistulas. The case, which will be discussed here, is of some interest for its anatomical features, for the diagnostic difficulties encountered during its recognition and for those operational procedures that were applied here.

39 members were present: Baskin, Baikov, Batsevich, Bidder, Vasten, Viridarskiy, Goraiskiy, Grinev, Danilovich, Dobradin, Dranitsyn, Zheltukhin, Zabolotskiy, Lichkus, Mazurkevich, Martsynkevich, Massen, Miller, Ott, Petrov, Petrovich, Popov, Radetskiy, Rachinskiy, Ruzi, Rutkovskiy, Salmanov, Sokolovskiy, Stravinskiy, Strogonov, Tarnovskiy, Ulrikh, Urvich, Fisher, A.R., Frank, Tsyrskiy, Chagin, Chernyshev, Shverdlov, Eichfus and 22 guests.

The author's views on the dietetics of normal childbirth (mainly, not in clinics, but in private practice) boil down to the following. If possible, the woman in labor should have a shared bath. Recognizing that there are microorganisms on the external genital organs of each woman in labor, he considers their disinfection at the beginning of labor to be unnecessary, since it would only make sense if possible to apply an aseptic bandage to the disinfected parts, which, for obvious reasons, is not feasible; in view of this, he advises at the beginning of labor to make only a thorough washing of the external genital organs and surrounding parts with well-boiled (depleted) water and soap, repeated after each urination or excrement.

A patient, tall and strong, about 30 years old, a woman was always healthy and only a month before that she began to feel sometimes cramp-like pains in the lower abdomen and notice leucorrhoea, which either intensified or weakened. Menstruation is correct from the age of 13, but the last meager regulations on April 30 were caused artificially, and on the third day there were pains with contractions, bringing the patient to fainting.

Fibroids complicated by pregnancy are rare, due to the age of patients, abortions with them and the fact that small tumors are often visible, and rarely increase; therefore the author reports his case. Having examined the literature on this issue, the author declares that the majority of authors favor waiting, if there are no threatening seizures; fewer are for reposition, even fewer for abortion, very few for artificial premature labor, and very few for surgery in the absence of severe seizures.

The author describes a case of retroflexionis uteri gradidi cum incarcerationе, which he had to observe a second time in the same woman.

Passion for laparotomy at different times of ectopic pregnancy is considered by most authors to be mandatory in the first half of pregnancy and the sooner the better; and even some authors are beginning to speak out for expectant treatment, even with internal bleeding as a consequence of such a pregnancy. In view of his enthusiasm for operational assistance in such cases, the author considers it necessary to collect more facts for and against and thus solve the question: when it is necessary to operate and when not. To this end, he reports three cases: two operational and one non-operational.

Having cited the scarce data available in the literature on this issue, the author proceeds to present the results of his pathological, anatomical and bacteriological investigation of one case of severe, fatal eclampsia.

From June 15 of this year, from the date of admission of the first patient with cholera to the Saratov city hospital, to August 28, 243 women were admitted, 121 of them died. The ratio of men to women is 1: 0.66.

In view of the extreme rarity of this disease (the author was able to find in the literature only one case of Roussaeux in the Gazette medicale de Paris, 1857), I will cite the history of the disease with a photograph literally: on April 22, a peasant N; 21 years old, medium build, pretty, with delicate white skin, correctly developed. As a child, she did not get sick with special diseases; there are no hereditary diseases or syphilis in the family. Menstruation from 14 years in the correct 3-week terms, 3-5 days. She got married at 20 and soon became pregnant. Gave birth on time 5 months ago. She got sick at the end of pregnancy. At 7 months, I noticed a particular enlargement of the right breast with thickening of the skin near the nipple.

Patient Anna I., 18 y.o. by birth, a peasant woman of medium height, good physique, a year before admission to the Izhevsk zemstvo hospital, she noticed a swelling in the lower abdomen, gradually increasing and causing severe pain, especially during menstruation. The first menstruation appeared on the 14th year and were established in 4-week terms for 2-3 days. The pregnancy that came soon ended in a two-month miscarriage. After that, the blood was again established at the correct time, and at the same time, abdominal pains appeared, forcing the patient to go to the hospital.

A 41-year-old patient who has not given birth; suffers from uterine bleeding for many years; systematic treatment with subcutaneous injections of ergotine; repeated curettage of the uterus with removal of fibroids the size of a volosh nut.

This article is quite a solid objection to the article by Doctor Lvov: removal of ovarian cysts and uterine appendages through the vagina, placed in No. 11 and 12 of the Doctor for the current year.

Brought up on foreign textbooks, we, Russian doctors, gladly welcome the appearance of any independent Russian textbook, and even more so one that, on the one hand, appears to be the fruit of tremendous theoretical erudition, on the other hand, an expression of experience acquired during "four decades" of practical activity. Midwifery course prof. Therefore, IP Lazarevich will inevitably and quite deservedly attract the attention of not only a specialist obstetrician, but also any Russian doctor who wishes to draw from him instructions and instructions for his difficult and responsible practical obstetric activity.