Vol 9, No 3 (1895)

Die einführung der rectalen inneren Untersuchung in die Hebammenpraxis ist eine Bankrotterklärung der besthender Desinfections vorschriften.

Sänger.

While in surgery and operative gynecology, asepsis has already triumphed over antiseptics, in obstetrics, thanks to the special features of this science and the more complex organization of obstetrics, we are going through a transitional era.

(Reported in the Society of Odessa Doctors on January 14, 1895).
On the evening of September 6, 1894, a pregnant woman was admitted to the gynecological department of Dr. Yuzefovich at the Odessa Jewish Hospital, which I temporarily supervised, with symptoms of septic peritonit on the 5th day after the onset of the disease. In the hospital, after the diagnosis of rupture of the pregnant uterus was made, laporatomia and amputation of the ruptured uterus were performed. The patient died on the 8th day after the operation. The gap in this case, as we will see further from the given history of the disease, occurred without any mechanical stroke, such as: fall, shock, etc. In view of the fact that the ruptures of the pregnant uterus occur extremely rarely and ethiology without ruptures occurring from outside — dark, I think it is not uninteresting to report the incident I have observed. This case is also of interest in the therapeutic relationship, the patient received proper help only on the 8th day from the onset of the disease. It can be said with more or less certainty that if this gap had been identified during the onset of the developing disease, then, with proper assistance, it would have been possible to prevent the onset of a lethal outcome.

The wealth of the instrumental arsenal of a modern gynecologist, in particular in relation to the instruments assigned for the expansion of the cervix, is so great that it can put a beginner in a difficult position regarding the choice of such an instrument, which could be limited.

It was chaired by V. I. Stolts.
1) Protocols Nos. VIII and IX were read and approved.
2) The revision committee of the members of Goraiskaya, Zamshin and Frank reported to the Company that during the revision of the cash desk, the last one was found by them in full order.
3) Revision commission from members of Eberman, Vasten and A.R. Fisher reported to the Society that the receipts and expenditures and, in general, all the bookkeeping of the editorial office of the "Journal of Obstetrics and Women's Diseases", for the expired 1894, were kept correctly. The reporting financial year, concluded with a cash balance in the size of two hundred sixty seven rubles 32 kopecks (267 rub. 32 kop.).

A 39-year-old pregnant woman, for 3 months, has a tumor in the navel area of 39.5 cm. in the circle of the base. The skin of the tumor (hernia) is thinned; the hernia is not reparable. During the operation (cut along the white line), it turned out that the contents of the hernia were intestinal loops and an omentum.

For 59681 childbirths collected by the author in Russian literature, ruptures were observed in 65 parts (1 in 1053 childbirths); for 2104061 genera collected in foreign literature, breaks were observed 1034 times (1: 1940). The author's case concerns a 25-year-old woman in labor who was pregnant at the seventh section. The previous childbirth was generally difficult. Real childbirth with violent contractions. After the release of a large amount of water, with the open for 3 fingers, contractions stopped and a slight bleeding appeared.

From the extensive literary essay given by the author, it is clear that at the present time, there are various views among obstetricians regarding the merits of this or that way of maintaining the last period. In general, the methods of conducting the last period are reduced to expectant processes (Ahlfeld) and to active intervention (Credé). The author, noting the shortcomings of both methods, asks the question, will it not be possible to have a single ligation of the umbilical cord (fruit end), smooth out the bad sides of the Credé method and Ahlfeld's method, while preserving their advantages.

The author was invited to a woman in labor, 26 years old, who had given birth safely 4 times before. Now her childbirth lasted unsuccessfully for 3 days. She was found by the author in a state of extreme decay, very anemic. External examination determined the presence in the abdomen of two tumors of unequal size. An inaccurate history and lack of fetal heartbeat made the author doubt the presence of pregnancy.

Of the five cases observed by the author, in four the pregnancy was interrupted, and one mother died, in one case the pregnant woman died without being allowed to die; the fetuses in all cases died. Despite the fact that in all cases severe cramps of the calf muscles were observed, the uterus remained flaccid.

Secondary, 27 years old. Births urgent. The contractions are painful, almost uninterrupted. With the weakening of pain and blood that appeared from the uterine cavity, a rupture of the uterus was noted with the exit of the fetus into the abdominal cavity. Gluttony. The gap turned out to be located on the back of the uterus with severely bruised edges. The uterus is amputated. The cervical canal is drained into the vagina with strips of iodoform gauze. On the 17th day after the operation, it was found that a descending intestinal loop was soldered into the cervical canal.

The author had the opportunity to observe the sick partly in the factory hospitals, partly in free apartments. By the way, noting the conditions that somehow affect the individual predisposition to cholera, he suppressed that the female sex in general, among the predisposing moments, occupies a rather prominent place here.

Dr. James observed in Cleveland, America, a pregnancy lasting over 10 months in a 27-year-old woman in her 5th pregnancy. The last regulations were with her on April 22, 1893, and on February 3, 1894, labor pains began, recognized by her midwife as false pains; the last day, indeed, ended soon. Dr. James, invited to her on 24/2/1894, found the cervix smoothed with no pain at all.

A woman who resolved from the 2nd pregnancy, on the 4th day after normal labor, developed a fever and a red rash on the legs and abdomen, similar to scarlet fever. The next morning, the rash spread all over the body. But the excellent state of health of the patient, the decrease in temperature to normal, the correctness of the postnatal separations, indicated that it was not scarlet fever. The rash quickly faded, the postpartum woman, who got out of bed on the 10th day, remained healthy. Anamnesis revealed that this lady had a similar spillage before her marriage; but during her first childbirth, nothing of the kind happened.

M. made an interesting series of experiments on the inheritance of the cylindrical epithelioma. He inoculated particles of the neoplasm to the white mice and after a while to the vaccinated mice that appeared on the day of the babies.

This operation, as it is known, consists in separating the anterior part of the urethra from the surrounding parts, more or less twisting of the urethra around its longitudinal axis and strengthening it with sutures on the same place, which creates a mechanical replacement of the urethral tissue from the elastic tissue of the urethra, a mechanical replacement of the urethra bubble.

The young woman, who considered herself pregnant, developed blood and pain after 5 weeks of pregnancy and lasted for six weeks. She was admitted to the hospital for the operation. In the left side of the pelvis, an elastic tumor the size of an orange was hidden, displaced the uterus to the right, and a stretched tube was felt behind the uterus. During anesthesia, the patient's breathing suddenly became superficial and the pulse weakened, the patient turned pale.

The contradictory opinions prevailing in the sciences regarding the use of the so-called objective antiseptics in obstetrics forced W. to discuss the controversial issue of asepticity or non-asepticity of female genital tracts, and he came to some results. The genital tract of an unexamined pregnant woman breaks up in bacteriological relation into two sections: the lower one, rich in microorganisms, and the upper one, completely free of microbes. The border between both sections is located in the middle part of the cervical canal and is caused on the one hand by constantly renewing cervical mucus, which is a poor nutrient medium for microorganisms, and on the other hand, by phagocytosis, which has a place in the lower part of the uterine cervix, due to the property of the vaginal secretion of the vagina. from the surrounding tissues.

Preliminary description of a case of complications of childbirth by two myomas sitting in the lower segment of the uterus, in which a Porro operation was performed at the Göttingen Clinic with success, and a critical review recommended by many surgical interventions during pregnancy (the author comes to an artificial abortion, and to the conclusion that in case of complications of pregnancy with myomas, it is best to wait for the onset of labor and timely amputate the uterus, since this operation gives the best results both for the mother and the fetus.

After detailed literary studies on comparative anatomy and based on the preparation of a very young human egg, the author resolves the controversial issue of the nature and origin of the cover of chiral villi in the following way. In humans, as in other animals, the cover of chorial villi of the dancer consists of two layers, one cellular layer originating from the embryo (ectoderm) and the other protoplasmic, which is a modified uterine epithelium (syncytium). Already at the beginning of the insertion of the egg, both of these layers are so tightly interconnected that they form, as it were, one tissue layer, on which it is not difficult, however, to distinguish its initial constituent elements.

Baer's doctrine on the benefits of a wait-and-see manner of action in facial situations is generally not disputed, but it pays little attention to the life of the fetus to regret. This circumstance often forced obstetricians to deviate from the wait-and-see principle and undertake the transformation of these provisions into the occipital. The practices that were practiced at the same time did not always lead to goals, since when acting on the head (the Baudelocque method), the body was left without attention, and when the lordosis of the trunk was transformed into kyphosis (the Schatz method), they did not care about movement at all.

I. Annular prolapse of the mucous membrane of the urethra (gangrenous); ripped out and seams; recovery.

Around November 20, 1894, a peasant woman Avdotya V — va, 21 years old, from the village of Usman came to the Usman outpatient clinic. A student with a complaint of frequent urination and that "there is a lump in the anterior external passage".