Vol 8, No 3 (1894)

Recently, instead of the antiseptic method, sterilization and aseptic methods have been increasingly used in operations in uncharged tissues. In the department of prof. Ott, at the Clinical Institute of the Grand Duchess Elena Pavlovna, the latest methods have been used for several years, and in general, a more favorable course of the postoperative period, more frequent receipt of primae intentionis wounds - this is the ideal of surgeons, both in large, and especially in plastic surgeries.

Ruptures of the uterus, being one of the most fatal complications of the act of childbirth, represent, by their etiology, in each individual case, and still a lot of dark sides. Bandl's classic works, which, according to Veit's apt expression, constituted an era in the teaching of uterine ruptures, are so carefully substantiated by the author himself and are full of such valuable indications for the symptomatology of a threatening rupture that for every obstetrician practitioner, they are still a guide thread in the prevention of this dangerous complication.

Attended by: honorary member K.F. Slavyanskiy, 38 members: Antipov, Baikov, Bankovskiy, Baskin, Batsevich, Viridarskiy, Voff, Hermonius, Goraiskiy, Danilovich, Dimant, Dranitsyn, Zabolotskiy, Krukovich, Lichkus, Massen, Piotrovich, Porshnyakov, Radetskiy V.K., Rachinskiy, Ruzi, Rutkovskiy, Rymsha, Savchenko, Sadovskiy, Serezhnikov, Stelmakhovich, Stravinskiy, Strogonov, Fisher, A. R. Fratkin, Tsyrskiy, Chernyshev, Shverdlov, Stolts, Shuttenbach, Eberman, Eichfus and 20 guests.

Leaving aside the ruptures of the uterus, depending on changes in the uterine parenchyma and malformations of the uterus, the author attributes most of the ruptures to neglected and incorrectly administered labor. He puts the degree of frequency of ruptures in direct proportion to the timeliness and nature of obstetric care in each case. Finding a negligible percentage of ruptures in almost all authors (0.01% -0.1%), excluding Leopold (0.3%), and comparing the incidence of uterine ruptures in Warsaw (18 ruptures per 3391 births, therefore, about 0 , 5%), the author explains this frequency of breaks by the irrational delivery of obstetric care. Several cases are cited to support this opinion.

In a second-bearing woman, on the 3rd day after the onset of labor, with a transverse neglected position (t° 38.8°; pulse 120), the author exfoliated both arms in the shoulder joint, perforated the spine in the lower cervical part, removed the lower part of the fetal body (with legs ), and then, having squeezed out part of the brain through the spinal canal, removed the head.

From these statistics we borrow the following. Of the 1,022 cancer patients who were during this time, there were 726 women, that is, 71%.

A peasant woman, 25 years old, is pregnant for the third time. Childbirth 8 weeks before due date; arrived with contractions.

There is, as you know, a method of supravaginal amputation of the uterus, according to which the stump formed by the remaining uterine cervix is not sheathed by the peritoneum, but simply captured only in the ligature; while, according to H. Treub'u, the ligature is applied only around the neck, en masse, according to the method practiced by prof. DO Ottom, ligatures, number from 2 to 4, pass through the thickness of the uterine wall, without capturing the cervical canal and thus leaving it passable.

The author first of all briefly examines the influence of the first menstruation and established blood on the body of a nervously healthy woman, noting that "the menstrual period of a healthy woman is not a disease, but it is not complete health." Menstruation in such cases, to a greater or lesser extent, upsets the balance of the nervous system in a woman. The influence of menstruation on the body of a woman with a nervous predisposition is more complex. In these cases, the influence of the appearance of the first menstruation is especially pronounced, when sometimes an insignificant moment is enough only for the girl to develop epilepsy, hysteria, atrial melancholy, etc. It also happens the other way around: the onset of menstruation improves the course of already existing nervous suffering, for example, chorea. The influence of each menstruation is less pronounced, when menstruation has already been established, while painful menstruation (amenorrhoea, menorrhagia) affect the nervous state of women more sharply

This extensive report covers both the maternity ward and the gynecological ward for the period noted.

On the basis of literary data and his own observations in 60 cases (in the hospital of Dr. Strauch in Moscow), the author speaks in favor of replacing chloroform with ether.

There is a known number of diseases of the uterus, depending on physiological disorders. They are manifested mainly by such signs as leucorrhoea, bleeding, etc., which are characteristic of true, that is, infectious metritis. The author divides all changes (diseases) in the uterus, excluding neoplasms and curvatures, into changes that depend on infection and do not depend on it. The name metritis, in his opinion, should be confined only to the first, that is, to the true inflammatory changes. Already in 1886, the author pointed out the difference between contagious metritis and physiological nutritional disorders that occur under the influence of disorders of the nervous, circulatory or lymphatic systems, or under the influence of trauma, incomplete reverse development, etc. These diseases include the names subinvolution, chronic hypertrophy, blockage, tide, etc., and the author calls them pseudo-metritis

The author proposes, in order to facilitate the extraction of the subsequent detached hydrocephalic head and lingering in the uterus, the following method, which he used in one case, after preliminary futile attempts to extract the head by the lower jaw, forceps, etc.

According to the author, electricity in most cases of uterine evasion is an excellent medical agent. It satisfies all three indications most often encountered in this suffering, counteracts the formation of dense exudates, promotes metabolism and restores the contractility of the ligaments that support the uterus. The author uses the apparatus of the Chardin system, the electrodes are a uterine probe with a carbon tip, described by Apostoli, and a zinc plate wrapped in felt and suede.

The author briefly reviews the drugs used in the treatment of urethritis in women.

This work is a serious attempt to solve experimentally the questions only outlined in the message of Lugeol.

The author reports a case of an ectopic pregnancy, which he operated under the following conditions: he was invited to a patient whom he found in collaps.

Nowhere has the study of bacteriology led to such brilliant successes as in obstetrics: thanks to antiseptics and asepsis, postpartum fever, which carried off a mass of women in labor to a premature grave, disappeared. But until now, eclampsia has remained invincible, resulting in many victims among pregnant women and women in labor. Although a number of recent studies have proven that seizures are caused by toxins that accumulate in the blood, as a product of the vital activity of special bacteria that develop in the body during pregnancy, we still do not know the conditions and reasons under which they develop.