Vol 8, No 10 (1894)

As often in the literature descriptions of cystic formations developing in the area of large lips, the number of cases of these formations encountered on small lips is so limited.

Acquired cicatricial narrowing of the vagina, which is quite rare, is of great interest in the therapeutic relationship for the obstetrician and gynecologist. What a serious obstacle is vaginal stenosis for a pregnant uterus during childbirth - can be seen from the article by Merz, posted in Archif für Gynäcologie, Bd XLV: for 230 cases of rupture of the pregnant uterus collected from the literature over the last 20 years, 16 caused vaginal stenosis. Timely removal of this obstacle would save 16 lives! It must be assumed that a huge number of cases, in addition, remain unpublished; in November last year (1893), together with my friend Dr. Bobkevich, I was a witness of the lethal outcome of urgent childbirth of a woman who had a second birth in the result of scarring contraction of the vagina.

D.O. Ott chaired.
Present: honorary member K. F. Slavyanskii, 45 members: Antipov. Balinsky, Bacewicz, Butchery, Wasting, Weber, Vertinsky, Wirearchy, Goralski, D., Dimant, Dobradinha, Dolinski, Dranitsyn, Zabolotskaya, Sunshiny, Kukushkin, Lapin, Lebedev, Lickus, Mazurkiewicz, Pulp, Petrovich, Polonsky, Recency, Rodzevich, rimsha, Savchenko, Sadowski, Salmanov, Serezhnikov, Sicinski, Stelmahovich, Stravinsky, the Land, Fisher A. R., Fratkin, Chagin, Chernyshev, Sverdlov, Schmidt, Stolz, of Luttenbach, Bermany, Eichfus and 63 guests.

Published by A.R. Fisher. SPb., 1894, 2 parts, XXXVІІІ + 629 pages and 369 pages.
When the thought arises of honoring a person who has worked for the well-known period of time in the scientific field, then there can be no talk about the advantages of any other gift adapted to the celebration, like the one that lies before us. In this collection of feasible works, one cannot look for personal feelings and worship, alien to scientific indifference; The feasible works of the collection serve only to express respect and devotion to the scientific foundations and goals, among which the activity of the hero of the occasion proceeded. For the last day, therefore, such a gift should be the most desirable, the most pleasant.

Patient 67 years old, does not wear blood since 50 years of age, suffers from 5 years of umbilical hernia and progressive enlargement of the abdomen. The hernia cannot be adjusted, the abdomen is greatly increased in volume. Above the hernia, the sound, when tapped, tympanic, with the sides - dull, passing at a distance of 4 fingers from the spine, in tympanic; below the hernia, the sound is dull. In the area of a dull sound, there is a ripple.

The author is skeptical about the fear of many modern surgeons who perform gluttony, the air and everything that is in the operating room at the time of the operation, although there is no contact with the wound controversy. In his opinion, the care of some surgeons to arrange their gluttons to the extreme strictly, in relation to the environment, is unnecessary. He himself operates in a private house. (unfortunately, there are no detailed instructions regarding the situation of his womb. Ref.).

The act of childbirth, even under the most favorable conditions, puts the woman in labor in a position close to pathological. If a woman in labor has a pathological inheritance, a personal neuropathic predisposition, and on the part of childbirth, there is any deviation from the norm, then the physical and mental state of the woman in labor cannot remain in the physiological limits. Cases of crimes during childbirth were noted by many.

24 / ix, the author, invited to the primiparous about the prolonged labor, finished labor with forceps. The child's place has partially grown to the uterine wall; with manual detachment, its accreted part of the membranes remained in the uterus; Successive attempts by two doctors to separate these remnants have been in vain. The postpartum woman resisted the stitching of a small perineal rupture. Appointed sublimate sleeve douching and idoform at the site of perineal rupture.

The author describes 2 cases of bleeding during pregnancy (5 months and 4 months), where, after unsuccessful attempts to stop the bleeding, he miscarried according to the method proposed by Peltzer. This method, as is known, consists in the fact that glycerin is poured through a catheter inserted a few centimeters between the walls of the uterus and the membranes. (Glycerin, having properties to irritate the mucous membrane of the uterus, acts more surely than water).

The description of the case seen by the author is preceded by an indication of the reasons for suppuration, in general. The established opinion that suppuration is caused by specific microorganisms (staphylococcus pyogenes aureus et albus and streptococcus pyogenes) and that where suppuration is present, the named microorganisms must be found there, is now abandoned.

The weakness of pushing, which is encountered so often in the practical activity of obstetricians and leading not very often to serious surgical intervention, which does not always end happily for the mother and the baby, made the more innocent people look for ways to fight it, than the operation. All currently available means of enhancing labor pains are not always effective, therefore it is completely understandable and desirable to search for new more effective means. The author, wanting to try any of the newly proposed remedies with the weakness of the labor pains, settled on a corn smut.

In 1893 and the beginning of 1894, the author observed five cases: 1) A peasant woman, 33 years old, married, giving birth, 3 months without blood. Attempts at an artificial miscarriage (midwife) caused a slight bleeding. The author, having identified a lingering tumor on the left near the uterus and assuming an extrauterine pregnancy, pierced the tumor through the vagina with a thin troocar and released about a teaspoon of liquid.

In the second-bearing, 22 years old, with a wide pelvis, the transverse position of the fetus with the handle falling out. Rotate and extract with a successful outcome. After childbirth, it was found that the postpartum woman had a clear form of a two-horned uterus (uterus bicornis, arcuatus).

Data on this issue, obtained by thirty-four authors, are collected in this article and developed. These data concern 64,759 cases. According to the conclusions made by the author, the first months of the inhabitants of Russia come on average in 15.83; most often at the age of 16, (216% of all cases).

Multiparous, 43 years old. The last three pregnancies ended in miscarriage. Suffering from bleeding. Recognition of backward bend, chronic metritis and endometritis. After an unsuccessful treatment with massage and rings, hysteropexia abdominalis anterior was made. After 8¹/₂ months after the operation, a three-month miscarriage. For several more than a year after the operation, its effect is not violated.

9-para, 29 years old. Childbirth ended with forceps (slightly flat pelvis). During childbirth, who were at home, a rupture of the uterus was ascertained. I arrived at the hospital with an unremoved post-dom, very weak, with the manifestations of the beginning inflammation of the peritoneum.

Making a brief outline of the pathology of narrowing of the cervical drip, the author points out the narrowing of the external opening, as a common cause (96%) of infertility in women and as a cause, together with inflammatory changes in the neck, painful months. When reducing the contraction, the author often resorts to cutting the neck (Sims) and praises this method.

In 28 years of healthy primiparous in 9 months of pregnancy, due to the strong, due to the presentation of the child's place, the bleeding was reduced when only 2 fingers were passable. The operation was performed on a transverse bed under chloroform anesthesia, which was immediately stopped after the leg was captured. When this last woman was taken to the entrance to the vagina, the woman in labor felt pain and strained herself greatly, and a stream of amniotic fluid with colored blood poured out of the vagina.

At the sight of postpartum hemorrhage, the doctor is usually so lost that he does not stop at the choice of means to stop it, often exposing the woman in labor in this way to the danger of infection, while the danger of further bleeding or of the whole does not exist, or can easily be eliminated by a more rational way. Truly, if you do not act rashly, but rather coolly to navigate every time unto the state of affairs, it is very easy to do completely aseptic measures, it is not resorting to such a dangerous manipulation, as manual separation of the placenta, the introduction of full hands unto the uterine cavity or even tamponato by iodine-phorme gauze. The cause of bleeding in the postpartum period is, as usual, either the injury of the soft parts, or the atony of the uterus.

Having described a new preparation for a child's place of 4 months of pregnancy, on the maternal surface of which there was an islet with a completely smooth decidual cover (reflexa), the author in this polemical article opposes Ahlfeld. in defense of his theory, according to which the presenting child's place arises due to the abnormal development of the placenta in the reflexae area.

The skepticism expressed by many manuals and practitioners regarding the success of the treatment of chronic metritis is based, as it seems to me, not on the fact that this kind of suffering is not at all given to treatment, but on the difficulties of the task that the doctor has to solve. The best here should be very long, (for which there is not enough patience on the part of the patients, as well as the doctor!) not only symptomatic, but strictly thought out for each individual case, representing its own individual characteristics, which have to be considered.