Vol 23, No 5 (1927)

This year marks the hundredth anniversary of the birth of Joseph Lister. Who among us does not know this name? Who among us does not know about the great upheaval to which surgery owes Lister? Who of the workers of culture and science does not care for the name of this benefactor of mankind, who saved the latter, by creating his system of antisepsis, from an innumerable series of unnecessary deaths and sufferings? Like a hurricane, Lister's doctrine burst into surgery and split it by a deep chasm into two periods - the period of old, pre-Lister's surgery and the period of antiseptic surgery.

The teaching of tumors, especially malignant ones, most clearly reflects the evolutionary phases in biological medicine. The doctrine of hormones brings it back to the path of the humoral theory, and the further growth of hormonology links it closely to the cellular hypothesis. Thus, for example, Zondek and his school explain the interaction between cell and hormone by the cell's electrolytes or the content of ions in it, namely, by the distribution of electrolytes within the cell and on its membranes; on this, according to Zondek, depends the variability of the incretin action proceeding in the periphery of the body, although each cell is the carrier of specific hormones received by it through blood or lymph. Hence, says Zondek, a variety of moments can change the structure of a tissue and with it its ability to respond to hormones, and the hereditary factors which determine the structure of the tissue (genotypic mode of response, Bauer) are of enormous importance for the clinical picture of the symptoms.

We will not touch the controversial question of the role of infection in the genesis of ulcers and will adopt the point of view of the French school (Duval, Roux, Montier, Girault), for which the concept of an infected ulcer is only a concept of a pathological-anatomical and clinical nature, related to the concept of the evolution of an already existing ulcer, depending on its secondary infection. This evolution of the ulcer, in the presence of a new ingredient of infection, creates some peculiarities in its clinical manifestation,-peculiarities which, in suitable cases, can and must be taken into account both in the choice of time and in the choice of method of surgical intervention. Thus, the question under consideration by us has not only theoretical character, but, as we will try to state below, acquires also a certain practical interest.

A pulmonary hernia, i.e. the protrusion of lung tissue through an opening in the wall of the chest cavity under the skin of the chest, is extremely rare. In contrast to the wall of the abdominal cavity, here the conditions for the occurrence of a hernial opening are very unfavorable, since the strong musculoskeletal wall of the chest presents serious obstacles to it. Not surprisingly, therefore, special conditions are required for the occurrence of a pulmonary hernia. Such conditions are: 1) congenital underdevelopment of the chest wall, e.g., a defect of the intercostal muscles. 2) sudden repeated increases of intrathoracic pressure, e.g. when coughing, playing wind instruments, etc., 3) trauma accompanied by violation of the integrity of the thoracic wall with subsequent replacement of the defect by a scar. The latter factor is predominant in the origin of pulmonary hernia.

So far, all attempts to prove the presence of a certain specific poison in menstruation must be considered unsuccessful. Even the question of such a specific toxin is called into question altogether, and the approach to this problem must be quite different from that which has hitherto been used by various authors. Gengenbach, reviewing in detail the literature on this question, concludes that it is more correct to speak not of a specific hypothetical menstrual poison, but of known toxicoses. Such toxicoses occur not due to the invasion of poison from outside, but due to the imbalance or regulation in the body of biochemical processes.

In 1918, the late Professor A. I. Lebedev applied treatment of some skin diseases with intravenous infusions of sodium bromide and obtained excellent results: eczemas, which could not be cured and had tormented patients for years, urticaria, herpetiform dermatitis, erythema exudative, were cured within a fairly short time exclusively with this method. In many cases, patients were relieved by this method from persistent and unpleasant relapses of these dermatoses. Although treatment with bromine salts and other per os of skin diseases, especially acute eczema, has a very long history, but such an effective result has not been noted by any author.

We investigated minimal amounts of iodine using the microcolorimetric method proposed by M. T. Lecco (in 1896) and developed in detail by Th. v. Fellenberg (in 1923). Basically, this method consists in binding all J, irrespective of its state (free J, iodide, iodate, organic iodine compound), with carbonic alkali and converting it into iodide (KJ), which, when acted on with sulfuric acid, releases free iodine, which stains chloroform red-violet color.

Diseases of the uterine appendages have always had a prominent place in the etiology of infertility. These were inflammatory and neoplastic processes resulting in changes which in most cases were already detected by bimanual examination, such as various types of saccosalpinx, tubal fibromas, salpigitis nodosa, cystic ovarian changes, tubal-ovarian cysts, etc. The mechanism of infertility in such changes is clear, but only with the introduction of Rubinʹa method into gynecological practice did the actual role of the Fallopian tubes in the origin of infertility become clear, or rather, began to become clear.

The toxic substance isolated by the authors from cultures of hemolytic puerperal streptococcus has all the properties of a toxin: it gives a latent period between inoculation and reaction, it is liable to heat, is neutralized by immune serum antitoxin, causes formation of immune bodies.

The author reports the results of the use of a biliary typhoid vaccine ("bilivaccine") as a prophylactic agent against typhoid fever obtained in S. Paolo (Brazil).

To 5-10 cc of blood from the ulnar vein, 3% acetic acid and 50% antiformin are added successively and diluted with absolute alcohol. The precipitate is washed with distilled water and stained by Ziehlʹ or Much-Weissʼ. In 20 cases of tbc appendages, acid-fastening bacilli were found in the blood of patients in this manner, but if the distilled water was passed through a Chamberland's candle, the result was negative.

Having made a number of experiments in this direction on animals, the authors were convinced that by using sanokrizin, it is possible to achieve complete sterilization of the lungs.

The author believes that the obstetrician should not play the role of a mere technical performer when deciding on indications for termination of pregnancy in tuberculosis patients. Experience has shown that a significant number of women who are referred for termination of pregnancy because of tuberculosis are found to be free of tuberculosis under close observation.

The author points out the advantages of fluoroscopy for determining the position of foreign bodies, the position of fragments in bone fractures and articular body injuries. Stereoscopy is especially valuable when examining ribs, vertebrae, and the skull, where numerous overlapping shadows confuse the picture, and a slight deviation from the norm cannot be determined by the radiograph.

The author, who observed bloody vomiting two hours after the operation according to Bier's method, without stitching the mucosa, believes that this bleeding was from the gastric wall, and not from the ulcer, since the latter was not touched during the operation.

In 4 cases of facial carbuncles, the author injected his own blood into the circumference of the abscesses and obtained complete recovery without an incision.

The authors successfully applied a modified Bascini method in 52 cases of inguinal hernias in men, which consists of replacing the suture on the muscle layer and aponeurosis by sewing a homogeneous tissue-muscle with muscle.

The author observed in 30-60% of patients operated on for goiter early or late departure of sutures, in 74% leading to the formation of fistulas, which did not heal up to 3 years.

In examining the relationship between cataracts and the general state of the body, and comparing the various theories that exist on this subject, the authors find that sometimes the cause of cataracts is a decrease in the amount of calcium in the blood. 

The author received rather encouraging results from rubbing the oil of sholmogra (a Brazilian plant), long used in the treatment of leprosy, into the conjunctiva of the eyes for trachoma.

The author tested the value of Camnitzer's Joseph's floridzine reaction with the floridzine-maturina preparation and obtained 95.6% positive results in pregnant women and 3.3% in non-pregnant women. The accuracy of the test decreases with increasing gestational age, so that pregnant women up to 1½ months gave 100% positive results, pregnant women up to 2% months - 93.4%, and pregnant women 3% months only 87.54% positive results.

The author performed experimental research on the toxicosis of pregnancy.

Pielitis in its pure form is rare, and usually the kidney itself is involved in the disease. The disease predominantly affects primiparous women. Premature arbitrary delivery is observed in 30% of all cases.

The author cites the basic principles he adheres to in the treatment of abortions. K. considers only heavy bleeding to be an indication for active therapy, and he considers medication therapy with simultaneous cervical and vaginal tamponade to be the best course of action.

For stagnant vesicles, the authors recommend sprinkling, and if it is not successful after 24 hours, uterine drainage.

According to Sahler, the cause of dysmenorrhea in those cases where there are no gross mechanical obstacles to the outflow of menstrual blood lies in the convulsive contractions of the uterine muscles under the influence of various factors, both constitutional and endocrine in nature, and neuropsychological, acting through the autonomic nervous system.

A total of 1104 patients were treated. Free of recurrence within 5 years 23.5 i.e. 21.3%. 206 were operated on, the rest were treated with X-ray and radium. Of those who were operated on within 5 years 40.79% were free of recurrence, most of them underwent prophylactic X-rays.

On the basis of both his own studies and data from a number of Moscow researchers and literary material, Prof. Y. A. Finkelstein came to a number of conclusions regarding this microbe.

The author describes keratoderma in a patient with gonorrhoeal knee and ankle joint disease.

The author recommends for this purpose intravenous injections of afenil (10% calcium chloride solution by Knoll) in a dose of 10 cc. Performing these injections once a day, it is possible, in acute and subacute gonorrhoids salpingo-oophoritis, in 8 - 12 days to obtain such results, such with conventional anti-inflammatory treatment are obtained only in 3-4 weeks, and doing injections on 2 times a day, it is possible already in 2-3 days to stop "acute adnexitis.

Dr. Mogilnitsky was convinced of the favorable results of lumbar puncture in 85 cases of hearing loss of various etiologies.

The author thinks that of the numerous theories of the occurrence of ozenosis, only two are worthy of attention, namely, first, the one that speaks of a specific causative agent, and second, the one that considers the cause of ozenosis to be the constitution.

"Fundamentals of Care for Maimed Children" is the third edition of the book previously published as A Brief Guide to Care for Maimed Children. The book is divided into eight chapters.

Session 23/III.
Dr. E. V. Sukhova showed a patient with lesions of conus and epiconus medullaris. Patient G., 44 years old, having no lues, abusing alcohol, fell ill in November 1923, with pains in the lower back and weakness in the legs, which forced him to remain in bed. Three months later, improvement occurred, G. began to walk, but his right foot continued to fail; no pelvic organ disorders were observed. At the end of July, 1926, after a number of colds, weakness in legs again, and after a few days, after a large drink, the paresis became very sharp, urinary incontinence, constipation, impotence developed.

At the clinics of Kazan University, evening outpatient appointments are open, exclusively for insured workers and employees.
130) Dr. Yenaleev, who was previously the deputy of the People's Commissariat for Health, was appointed as the People's Commissariat of Health of the Tatrespublika. T. Enaleev, the son of a peasant, during the war worked as a pharmacy paramedic in the army, in 1920 he entered the Moscow Medical Institute, after which he was appointed to the disposal of the Regional Committee of the TR.
131) A question has been raised about the establishment of a medical technical school in Kazan for national minorities, namely, Cheremis, Mordovians, Zyryans and Votyaks.

In view of several cases of request to me to make "vaccination against pregnancy" by spouses, I ask not to refuse to inform: 1) To make single or multiple introduction of a sperm, and if multiple, in what intervals? 2) Is the semen administered in its pure form or in a warm solvent, and what is its dosage? 8) What is the technique of obtaining inoculum? Physician Panin.
Answer. At present, I do not use sperm inoculation to prevent pregnancy, since a special vaccine has been developed by me (in cooperation with Dr. E.I. Zabolotskaya). This vaccine is a carbolized physiological solution of NaCl, in which hetero-spermatozoa are suspended, killed by acetone. One cc contains 300,000 spermatozoa. Vaccinations are given four times in increasing doses with a 7-day break. A new single vaccination is required after 4-5 months. The vaccine is not commercially available, as it is still being tested. Experimental data and isolated observations on women have given quite favorable results. I hope to put the vaccine on sale as soon as it has been tested.
Prof. M. Tushnov.