Vol 7, No 1 (1893)

The subject of my lecture is the pathological and anatomical studies of some organs of women who died in seizures of eclampsia. Partly on the basis of these studies, which to a certain extent confirm the data of the authors who worked on this issue earlier, partly on the basis of the results of urine analysis and some purely laboratory observations, I will allow myself to give a new explanation of the origin of eclamptic seizures in pregnant women, women in labor and postpartum women.

Taking advantage of this summer's epidemic, we, at the suggestion of prof. KF Slavyansk, engaged in the study of pathological and anatomical changes in the female genital organs with cholera. These observations seem all the more noteworthy because the authors who have worked up to now in this direction have come to almost opposite conclusions.

The modern trend towards conservative laparotomy in gynecological operations is a sign of the times. It appeared as a reaction against the hobbies that many doctors suffered, thanks to the success of laparotomy, as a result of which the opening of the abdominal cavity became almost unpunished.

A.I. Kraskovskiy, at the request of KM Sapezhko, who was absent from the city, showed the society a patient in whom Dr. Sapezhko, by cutting the lower part of the sacrum, excreted an intrapelvic tumor that turned out to be sarcoma during microscopic examination; the postoperative course was complicated by slight bleeding after removing the dressing and the formation of a fistula, cured by curettage; the patient is now feeling fine. This patient is also interesting in that she has already been shown to society twice as a rare example of long-term retention in the uterine cavity of the head separated from the trunk (see prot. No. 38 and 40). This case will be communicated to the public in even more detail.

Having briefly examined the existing methods of initiating artificial premature labor and finding them not entirely appropriate and safe for the mother and the fetus, the author cites his observations on the use of glycerin in the Cologne obstetric institution in order to excite and enhance the labor of the uterus: from the given birth histories, it is clear that intrauterine injections glycerol, this goal is achieved quickly, without the slightest harm to the mother or fetus, and without any change in the usual mechanism of childbirth, and glycerin, over other commonly injected liquids, has a great advantage in its antiseptic properties.

Not so long ago Drapes ("Quarterly therap. Review") suggested vinum ipecacuanhae in the amount of 2-3 times 10-15 drops each, as a good remedy for the weakness of labor pain for the excitation of perfectly correct contractions of the uterus.

Unfortunately, The benefits of Lister's antiseptic science, says Fehling, have been taken advantage of by gynecology to a much greater extent than obstetrics. From obstetric operations to caesarean section, Lister's scholarship brought more benefits than forceps and perforations. It would therefore be desirable that in the future, artificial premature birth under the influence of anti- and asepsis would give both the mother and the fetus better results than at the present time, and then only this operative aid in a state will be replaced, as a cesarean section with conditional shown and perforated.

Ms. Ch., 26 years old; poor health; started to walk at the age of 6; the first menstruation - at the age of 12, got married on the 19th and immediately became pregnant. The first birth, which lasted 46 hours, ended with a craniotomy at the Obstetric Aid in Moscow; the second pregnancy was artificially terminated by the author at the end of the 24th week, - a living child was born, died after 7 weeks from congenital weakness; The author interrupted the third pregnancy at the 36th week, and the labor was completed by the difficult imposition of forceps on the head moving above the entrance to the pelvis, - the girl was born in asphyxiation, revived. The present, fourth, pregnancy proceeded as follows: the last regulations between March 7 and 10, 1891; first fetal movement - July 24; only on 30 November (i.e. at the end of the 38th week) did the pregnant woman turn to the author.

Although very significant results have been achieved in the field of obstetric antiseptics in recent years, it cannot be denied that some aspects of this case still cannot be considered finally resolved; this should include mainly the questions about the importance of preventive disinfection and about the limitation of internal research of women in labor, which have been subject to lively discussion in recent years. The author, on the basis of the material of the Erlangen obstetric clinic, tries to approach the solution of these controversial practical issues closely related to the current state of our knowledge regarding the bacteriology of the internal genital organs of pregnant women and women in labor ("self-infection").

The author first of all points out the qualities that a good nurse should have. She must not be younger than 20, otherwise she is not experienced enough and not strong enough to feed a baby. In addition, the milk of a woman from 16 to 20 years old contains relatively little water and sugar, and a lot of casein and fat, in composition it is close to cow's milk and is difficult to digest. On the other hand, a nurse should not be older than 35 years, because at this age a woman's milk contains a lot of water and few dense constituents; such milk is not very nutritious. The time of the woman's release from the burden is of great importance. It is best to take a woman as a wet nurse no earlier than 3 months after her birth.

The author recommends to be more careful when using objects for the expansion of the uterus, which are on sale, in view of their poor processing or due to a simple mistake of the manufacturer, and cites one of his observations in this regard, made three years before.

Sleeve breaks during copulation are very rare, some authors even doubt their possibility.

The author considers laparotomy to be the best surgical remedy against backward curvature of the uterus. Prior to her, he advises to try treatment with pessaries, especially in cases where the appendages are healthy and the uterus is mobile, small in size and the disease is not acute. In cases of complications with metritis, perineal rupture, you should first heal them and then apply a pessary. Analyzing the operative methods of retroflexion treatment, the author divides them into the following categories: vaginal surgery, Alexandr's surgery, hystéropexia and laparotomy.