Vol 7, No 4 (1893)

In the life of an individual scientific institution, as well as in the life of an entire society, there are certain periods, trends and trends are known, which, taken together, constitutes the history of this institution. These institutions, which have their own history, include university clinics. The history of these scientific and medical institutions usually has both bright and dark periods, depending not only on a purely scientific setting of the case, but often also on outsiders who have nothing in common with science that have no influence. Here, in a strictly scientific work, this is not the place to go into detail about such influences, but I would like to point out one of them as deserving special attention. This is the dependence of the clinic on city hospitals; it appears in the case when the University acquires one of the premises of city hospitals for clinical purposes. If the hospital business generally went hand in hand with the clinical one and pursued the same goals, then of course the interests of both that and the other institution would be completely identical and would not contradict one another.

In the past 1892, several interesting cases were observed in the maternity ward of the Kharkov obstetric clinic. One of these cases I had to carry out, with the permission of the deeply respected professor N.F. Tolochinov, I find it worthwhile to describe, since it presents some, rare and little known, features regarding the mechanism of childbirth. In this case, there was the so-called posterooccipital presentation, in which there was a change in the position of the head, which had already descended into the pelvic cavity.

MO Kleinman reported "a case of a vaginal septum obstructed during labor." A fleshy septum, thick as a goose feather, going from the anterior wall of the vagina to the posterior wall, prevented the forward movement of the child, who was in the second leg position in the anterior view. When the child was removed, the septum first caught on the gluteal fold, and then on the right axillary cavity; it was cut with scissors between two ligatures.

Opinions on the issue of embryonic rickets are far from agreeing. Only microscopically investigated cases can be considered as evidence.

The variety of views on the diagnosis and treatment of ectopic pregnancy and the need to collect and process casuistic material in order to establish accurate recognition and indicate the best treatment methods in this way prompted the author to report the case he observed. But before the message, its author gives a short historical essay, in which he sets out the views of authors of different periods on ectopic pregnancy, briefly gives statistics on the frequency of ectopic pregnancy and the views of the authors on its etiology: blockage of the fallopian tubes (Fritsch, Virchow, Hecker) caused by inflammation, kinks and fixations, false membranes; postpartum diseases of the peritoneum, plaque in the tube (Leopold, Beck, Wyder), preventing the entry of the egg into the uterus; intramural uterine fibroids (Olshausen, Roth von Macdonald), which apparently prevented the entry of eggs into it; purulent diseases, probably (Martin), affect either the loss of the ciliary epithelium, which slows down the movement of the egg, or the infiltration of the walls, which reduces the lumen of the tube; short-term swelling of the mucous membrane of the tube, the lower position of the peritoneal end compared to the uterine end (Pallen Freund); underdeveloped (infantile) pipes with their bends, etc.

The author had to observe a 60-year-old woman in whom two vertebral bones protruded from the fistula of the abdominal walls.

The author, examining the cases of twins from the Marburg and Dresden clinics, as well as from his private practice and literature data, a total of 145 cases (of which 101 are from two eggs and 44 from one egg), comes to the following conclusions.

Osteomalacia is mainly reduced to changes in the bones - they lose their mineral substances and along with this, abrupt changes occur in the organic structure of bones and in the bone marrow - and the bone and bone marrow soften. Along with this, degenerative changes occur in the muscular system. The clinical picture is first expressed by pain in different parts of the skeleton, early fatigue, increased reflexes; then, with strong development, bone curvature, persistent catarrh of the respiratory and digestive tract; patients die with symptoms of insanity. The disease lasts from 1 to 10 years and affects mainly women who have already given birth. Neither poverty nor prolonged feeding seems to matter.

The author describes a fibrous polyp, the size of an apple, extending with a short, little finger-thick leg from the posterior right wall of the vagina and performing the posterior fornix. - The diagnosis became especially clear when the tumor was pulled with bullet forceps. A ligature was applied to the base of the pedicle and then the entire tumor was removed.

The author reports 3 cases of extrauterine blood tumor; in the first two cases, surgical treatment was used (incision of the tumor through the vagina), in the third - expectant treatment.

By June 1, there were 31 patients in the department; for the reporting period, it was again received: with diseases of the external genital organs — 7, with diseases of the genitourinary organs — 1, with diseases of the uterus — 15, with diseases of the tubes and ovaries — 4, with diseases of the pelvic peritoneum and cellulose — 8, varia — 4 and obstetric cases - 4.