Vol 11, No 5 (1897)

Childbirth is a pure physiological act, which in the vast majority of cases nature brings to the end with its own efforts. The role of an obstetrician should only be to observe the wise actions of nature, and occasionally to help her in cases where childbirth takes an unnatural course that threatens the life of the mother or fetus. Our help, aimed at preserving these two lives, must be strictly justified, deeply thought out, decisive and quick. It seems that nowhere is the classical admonition so appropriate: "priusquam incipias consulto et ubi consulueris, —maturo facto opus est."

October 28, 1896 arrived at the hospital, sent to me by Dr. Isserson from Bialystok, a resident of the same city, married NM, 40 years old, dark-brown, short, anemic, pale, poorly fed; gave birth 12 times, the last - 2 years ago. Monthly after childbirth appeared in her every 4 weeks, abundant; the last two months - bleeding associated with persistent pain. Examination revealed a tumor, the size of the head of a newborn child, filling the entire lumen of the vagina, with a surface covered with a gray-yellow bloom. In its upper part, the tumor is narrowed and enclosed by the pharynx and cervix. The protruding finger easily passes between the anterior lip of the uterus and the tumor into the uterine cavity and palpates the continuation of the tumor, which constitutes its leg, 3-4 fingers thick, emerging with a wide base from the posterior wall of the uterus. The posterior lip of the uterine pharynx is fused with the tumor. The uterus itself is enlarged and mobile.

To narrow basins, following the example of previous reports from our clinic, we include those basins, Conj. ext. which are less than 18 centimeters and from cans with conj. ext. — 18 centimeters those where narrowing of other sizes, or anamnesis, or deviations from the usual mechanism of childbirth made it possible to suspect an irregularity in the device of the pelvis.

Ovariotomia duplex cum amputatione uteri supravaginale and ovariotomia simplex sinistra are described here.

Having described the methods of removing the uterus through the vagina using tweezers and pointing out the advantages of tweezers over ligatures (simplicity, speed and easier operation technique: the postoperative period is shorter) and their disadvantages (the possibility of bleeding after removing the tweezers, bedsores on the peritoneal lining of the intestines and in the vagina), author proceeds to describe his case of canceris colli uteri, where he produced extirpatio uteri per vaginam in the manner of Péan-Doyen.

The indications for these operations were: complete prolapse of the uterus, uterine fibroids, salpyngitis hypertrophica dextra cum retroversione uteri fixata, neoplasm of the bladder and neoplasm of the ovaries.

The patient suffered from hysteroepilepsy. The use of metal therapy together with suggestion significantly improved the patient's condition; then the patient became pregnant.

       Noting cases from Russian and foreign literature about the use of warthogs in uterine cancers and pointing out the contradictory results of the above observations, the author describes his case of canceris canalis cervicalis with infiltration of both lateral arches.

The case concerns a 15-year-old girl who was admitted to the hospital with a complaint of pain in her left leg and lower abdomen.

Three patients with a cancerous lesion of the uterus were injected every other day and less often injections of celandine extract solution into the affected areas, tamponation with an extract solution, sometimes celandine was given inside.

The case described here concerns a 34-year-old woman who gave birth 6 times, now full-term, now premature, now living, now dead babies, now with medical help, now without her.

In order to avoid when examining and examining healthy subjects of all kinds of mirrors (uterine, rectal, nasal, ear, for the urethra), which are also used in syphilitis, the author proposes to introduce into general use for the notorious syphilitis special mirrors, which could never be anywhere miscible and which could be quickly and unmistakably distinguished from others like him through sight and touch.