[On the history of surgical treatments of peritonitis]. / Zur Geschichte der Peritonitisbehandlung.

The surgical treatment of peritonitis started with the first laparotomy for an infected ovarian cyst by McDowell in the beginning of the 19(th) century. Thereafter the surgical approach developed parallel to the advances in abdominal surgery. In the last decade of the 19(th) century Mikulicz felt that laparotomy was indicated in all patients with purulent peritonitis. In the beginning of the 20(th) century Körte and Kirschner defined the principles of surgery for peritonitis that are valid up to this day: early surgical intervention, elimination of the source of infection, and peritoneal toilet. Since that time surgeons have discussed the utility of draining and irrigating the peritoneal cavity. Postoperative lavage was already advocated in the beginning of the last century, but generally regarded ineffective. Thirty years ago postoperative lavage was again strongly advocated, but evidence for its benefit is still missing. The history of the treatment of peritonitis examplifies that basic concepts which have been discovered in the past often remain valid and can serve as guidance for a long time. Such discoveries deserve recognition and should give reason for a critical appraisal of current practice. Thus, the statement of Trendelenburg made one hundred years ago remains true: "...in medicine, too, the today is based on the yesterday, and to follow a gradual development is of immense interest. In daily practice, especially in surgery and obstetrics, many things are much older than an ignorant can imagine."

Historia de las manifestaciones gastrointestinales del lupus eritematoso sistemico / History of the gastrointestinal manifestations in systemic lupus erythematosus

En este articulo revisamos la historia de las manifestaciones gastrointestinales en el Lupus Eritematoso Sistemico desde el siglo XIX hasta nuestros dias, recorriendo cada uno de los organos involucrados en este sistema y haciendo especial mencion de la gastropatia, enteritis, ileitis, sindrome de malabsorcion, vasculitis y vasculopatia intestinal, trombosis mesenterica, pancreatitis, ascitis, peritonitis, hepatitis autoinmune, entre otros

[Alexander Pushkin's duel--biographic and medical aspects]. / Aleksander Pusjkins duell--biografiske og medisinske aspekter.

The great Russian poet Aleksandr Pushkin (1799-1837) died 46 hours after being wounded by a pistol shot in a duel. The bullet penetrated the right pelvic bone, continued through the lower abdomen, and crushed the right part of the sacral bone. Biographical events leading to the duel are presented in the article, which also reviews articles in Russian medical journals describing the extent of the trauma and discussing the treatment possibilities at the time of the duel as well as present-day treatment. It is concluded that death was caused by peritonitis and that only modern extensive abdominal and orthopaedic surgery combined with antibiotic treatment could have saved the poet's life.

Infections within the peritoneal cavity: a historical perspective.

Physicians in antiquity dreaded abdominal infections. Despite the fact that peritonitis was extremely common, reports of successful surgical interventions were only anecdotal before the past century. Medicine's comprehension of the pathophysiology of the peritoneal cavity is still evolving. The history of our understanding of the process could be considered to be as recent as the current literature. Despite this, the mortality rates for patients with secondary peritonitis have fallen in the last century from almost 100 per cent to less than 10 per cent.

[Champagne administered by spoon for peritonitis after cesarean section. From the history of obstetrics in Erlangen--data from about 60,000 deliveries in 100 years]. / Bei Peritonitis nach Sektio Champagner löffelweise. Aus der Geschichte der Geburtshilfe in Erlangen--Daten von rund 60,000 Entbindungen in 100 Jahren.

The University of Erlangen has been engaged in clinical obstetrics for approximately 170 years. During this time, Erlangen University's delivery house, opened in 1828 and at first having considerably less than 50 births a year, developed into a perinatal centre with approximately 1,700 births a year. For the period from 1880 to 1981, a group of MD students reviewed the existing records and evaluated 60,000 births with respect to more than 40 parameters. Part of the results obtained are shown with special reference to operative obstetrics. Apart from the general influence of the scientific development on decisions and results within obstetrics, individual factors were also recognizable, factors which are linked with the experiences, insights and specialized working areas of the particular head of the hospital.

Bacterial translocation.

The phenomenon of bacterial translocation, the movement of viable indigenous microorganisms across the intestinal epithelial barrier, has been recognized for almost 100 years. At the present time, the precise mechanism of microbial transport is unknown. Active epithelial uptake and phagocyte-mediated transport have been proposed as likely explanations for the extraintestinal movement of bacteria to mesenteric lymph nodes and distant organ sites. Translocation has been proposed as the pivotal process associated with intestinal origin portal sepsis in seriously ill and immunocompromised patients. While several etiologic factors can be implicated in the pathogenesis of bacterial translocation, the present clinical implications are based almost solely on studies of dogs, rats and mice. Present investigations continue to suggest a causal relationship between intestinal mucosal integrity and infection by indigenous gastrointestinal bacteria.