Vol 30, No 9 (1934)

In the Soviet literature on tbc, especially in recent years, there has been an extensive discussion of the clinical features of the course of tbc in the countryside. The indisputable position is that TB infection of the rural population has been widespread in the distant past. This is confirmed by old surveys of the rural population of the 1990s, by the large number of TB infections found in remote areas of the Union during expeditionary surveys, and by the experience and observations of all doctors who have lived and worked in rural areas for a long time.

The issues of rational use of the ability to work and the employment of tuberculosis patients acquire serious practical importance as socialist construction unfolds. Timely and properly conducted employment should be considered as prevention of early disability of tuberculosis patients. Disability due to pulmonary tuberculosis is of great social importance. In the etiology of disability at the working age, from 20 to 40 years old, tuberculosis still plays a dominant role, accounting for over a third of all disability.

Since 1924, our clinic has been developing the issue of tuberculous bronchoadenitis in adults, to which we attach great clinical importance. The diagnosis of tuberculous bronchoadenitis is made when interscapular blunting is detected by means of fine-plane percussion, proposed by academician Hausman, and positive reaction to subcutaneous injection of altuberculin.

In recent years, there has been a profound revolution in the science of microbes. The world of these creatures, which seemed primitive and stable, turned out to be much more complex when studied in depth. On the basis of precise observations and facts, which have been accumulated over 50 years, it has become clear that it is necessary and possible to put this material in order and formulate a new doctrine, the doctrine of microbial variability. This new doctrine, a new interpretation of some of the already known phenomena, significantly expands our horizon, supplementing and deepening everything that was created by the founders of medical bacteriology. On the basis of the new doctrine, much in the clinic, i.e., in life, is illuminated differently.

Pulmonary tuberculosis with its most complex symptom complex and various effects of tuberculosis toxaemia on almost all major organs of the human body, although it has created its own huge therapy problem, however, to date it has not yet found its definite and exact method of treatment. Among a number of various methods of treatment of pulmonary tuberculosis only collapsotherapy, and mainly artificial pneumothorax, has recently managed, indeed, to take a rather solid, solid and almost true place in the problem of tuberculosis therapy. Some limited use of pneumothorax continues to encourage a number of clinicians and researchers, both in your Union and in Western Europe, to look for more and more new and more correct ways to treat tuberculosis in general and pulmonary tuberculosis in particular.

When using an artificial pneumothorax (i.p.) there are often cases when it is the diseased part of the lung that cannot be compressed because of pleural adhesions, as a result of which the cavern continues to gape, the patient excretes sputum and bacilli, and continuation of i. i., in fact, is completely aimless. In rare cases, when the adhesions preventing the recession of the cavern are very thin, it is possible to rupture these adhesions by forceful blowing and bringing them to positive pressures. However, this method cannot be recommended for a number of reasons.

Every phthisiatrician with a sufficient number of patients with artificial pneumothorax knows that the success of treatment with this method often depends on the condition of the pleura. Where pleural adhesions prevent collapse of the affected part of the lung, the artificial pneumothorax (i.p.) mostly does not reach its goal. More often such adhesions are found in the upper pulmonary field.

The literature on the role of mixed infection in tuberculosis is immense. It suffices, for example, to point out that abstracts on this subject were the subject of special papers at the tuberculosis congresses of 1899, 1900, 1907, 1923, and 1925; and works in this direction continue to appear to this day.

Over the last 10-15 years, treatment of tuberculosis patients with artificial pneumothorax has become widespread and there are many works devoted to collapse therapy in the press; details of the technique, efficiency of treatment, and complications are discussed. Spontaneous pneumothorax (SP) is one of the most dangerous complications of pneumothorax. Under p. p. we understand gas accumulation in pleural cavity in case of lung perforation, as the result of pathological process in the lung, more often of subpleural cavernous cavity breakthrough, caseous focus, or due to lung parenchyma needle trauma while applying pneumothorax.

If the case of tetany is given in the present work, it is done not because this disease is rare, but because our case is interesting from the point of view of the etiological moment, which gave such pronounced symptom complex of tetany. The fact that tetany is an expression of hypofunction of parathyroid glands is considered incontestable after the work of Erdheim, the experimental works of Gleil and others.