Vol 24, No 11 (1928)

The thirty years that have passed since the death of Professor G. A. Zakharyin of Moscow University are a sufficient period for the name of Zakharyin to be considered historical; it is also such in the importance that G. A. It is of such importance in Russian medicine. I, who began my medical work in the clinic of Prof. P.M. Popov, the closest successor of Zakhariyn and his pupil, where the traditions of Zakhariyn's school were especially preserved, should like to dwell on some features of the life and activity of G.A.

The question of the possibility of life-long blood washing, for the first time put forward by Professor I.P. Mikhailovsky in 1914, was actually proved by him in 1924-25 by experiments on dogs poisoned by supralethal doses of morphine injected directly into the blood. At the same time it was found that washing the blood of these animals while alive saved them, while the control dogs, i.e. left to themselves after poisoning with morphine, all died of acute intoxication. These experiments raised a number of very important questions, the experimental elucidation of which was the urgent task of the proposed method, and without a satisfactory solution of which the use of the latter for the purposes of practical medicine was not possible.

The question about the genesis of hypertension is still very unclear. Every year we meet in the literature revision of this pathological phenomenon and construction of new theories to explain it. It is known that an increase in blood pressure accompanies some diseases: nephritis, lead poisoning, tabetic crises, and in these cases the etiology of hypertension is associated with the nature of these diseases; in essential hypertension the etiology of the increase in blood pressure remains unclear, why exactly these forms of hypertension and cause so much debate.

The brilliant successes of bacteriology at the end of the 19th century and at the beginning of the current century so overshadowed the purely epidemiological study of infectious diseases that the focus began to be mainly on the bacteriological resolution of questions of an essentially epidemiological nature (the question of transmission, spread and course of infectious diseases). Koch's triad was a purely deductive principle, and the emergence of infectious diseases was postulated by the existence of those or other, but necessarily specific pathogens-discovered, or, due to the imperfection of our technology, not yet discovered. But already in the first decade of the present century individual voices of infectious disease specialists who express doubt as to the correctness of a purely bacteriological approach to the solution of epidemiological questions began to be heard, and the time after the war, which gave a great number of observations of an almost experimental character and precision, made it think that epidemiology could have its own method and experience.

A total of 6 cases of tbc of the male genitalia were observed with us: 1 case of both appendages and 5 cases of testicular involvement, including one case of bilateral involvement. Of these patients, who were admitted to us in a serious condition, three underwent surgery, while the rest were treated conservatively according to Hotz-Grekov; of the last three patients, one was recently operated on at the Provincial Hospital. For all six cases fatal outcome can be noted once, one month after surgery (at home) from lung tbc.

Even in ancient times, attention was drawn to various abnormal phenomena occurring sub coitu (painful sensations reaching the point of fainting, damage to the genitals, etc.), which were then mainly attributed to the abnormal size of the penis. In the medical literature such cases were first described in 1621 in an article by Plazzonus De partibus generatione inservientibus, which describes a case of formation of recto-intestinal-vaginal fistula on the grounds of sub coitus trauma. Neugebauer was the first in 1899 to collect a casuistry of vaginal injuries sub coitu, with 157 cases. After him, S. Rogov collected 16 such cases, Raspopova-Vinogradova-20 and A. Wert-18 cases.

In this article I will not dwell on a detailed description of all reflexes of the upper limbs. Such work seems unnecessary in view of the fact that the German author Kurt Tiefensee in 1925 in his extensive work entitled "Die Reflexe an den oberen Extremitäten" summed up quite successfully our knowledge in this field, having described and tested on material of the Koenigsberg psychiatric clinic all 20 upper limb reflexes known at that time, and the Russian author, employee of the Kazan psychiatric clinic, gave on pages of Kaz. Med. in 1926 he gave a detailed abstract of Tiefensee's work, thus making the results of his research available to all Russian physicians. Here I will remind readers of the 20 upper limb reflexes described by Tiefensee and then proceed to describe six new upper limb reflexes discovered by various authors in recent years.

Several years have passed since Bezredko's major works (1921) and the publication of his book "Local Immunization" (1924) (1), during which time much material has accumulated in all specialties, particularly in ophthalmology. During this time experimental and clinical works have multiplied. These data allow us, after summarizing them, to form an impression of the benefit that local vaccine therapy can bring to the treatment of eye diseases. At the same time, the teaching of the antivirus itself has been enriched by a large number of firmly established facts, which we shall briefly describe.

According to the author, radium has a specific effect on cancer cell nuclei, causing their pycnosis, nucleus deformation, vacuole formation, nucleus wrinkling and disintegration. The surrounding connective tissue is not involved in the specific changes. L. attributes a very important importance to special spindle-shaped cells (carcinomatogenen Stiftzellen), which penetrate into cancerous masses and disconnect them.

The technique of recording the venous pulse, according to the author's suggestion, can be simplified and refined by introducing a glass capsule with two hooks, between which a rubber band is put, tied around the examinee through the right clavicle and the left armpit.

Автор применяет для этой цели наперстянку,—сердце тогда выносит разные вредности заметно лучше. При этом препараты, содержащие и дигитоксины, действуют сильнее, чем освобожденные от него.

Having studied the breath-hold test proposed by Gönczu on 53 patients with heart, kidney and vascular diseases, the author found that establishing the duration of breath-hold is a simple and reliable method of determining the efficiency of the heart.

For this purpose, the authors recommend injection of emulsion or iodoform suspension in glycerin, olive oil or ether 1:9 into pleural cavity, and injection, in an amount of 1-2 c.c., is done once, at most 2 times. According to the authors' observations with this method, the exudate is resorbed faster than with any other method.

According to the observations of the author between the disease of ascarids and blood eosinophilia, undoubtedly, there is a certain correlation; therefore, after expulsion of ascarids the content of eosinophils usually decreases. The fact that eosinophilia is observed only in half of cases of ascardiosis, the author puts it in a causal connection with constitutional moments.

According to Воshamer, all ether anesthesia has a known harmful effect on the liver, which is significant in those cases where this organ has been previously affected, even if its disease has remained hidden. In such cases regeneration ability of hepatic parenchyma, apparently, weakens.

The author was convinced that the strength of silk ligatures decreases considerably when they are boiled in introduction, while during steam sterilization in an autoclave, if the steam is released before the threads are extracted, the silk strength, on the contrary, is not affected, and immersion of silk threads in sterile mineral oil makes them more strong.

After examining 112 skulls, the author verified that the distance between the outer edge of the fissurae orbitalis inf. and the tuberculum articulare was 5.7 centimeters, and the distance between the fissura orbitalis inf. and foramen ovale was 5.6 centimeters, i.e. 1 mlm less.

During 3 years the author successfully used the following mixture for treatment of cold abscesses: metal iodine 6.0, guaiacol-10.0, chloroform-60.0, almond oil-40.0. The mixture is sterilized and after emptying pus from the abscess is injected into the latter.

In 42 cases of application of hypertonic saline solutions in ileus the author observed an improvement in the general condition of patients and a decrease in postoperative mortality from 50% to 11%. The author suggests that hypertonic saline solutions neutralize toxaemia observed in ileus.

The author cites 74 cases of this disease, of which 35 were observed by the author himself. In terms of long-term results, all these cases can be divided into 2 groups: 1) cases with a good functional effect-58, or 78.4%, and 2) cases where significant limitation of mobility and persistent claudication remained,-16 (21.6%). In addition, 9 of these 16 patients remained suffering from pain, reducing their ability to work.

The author suggests the following method of treatment: after a vertical incision running from the cranial process to the lower edge of the m. The author suggests the following method of treatment: after a vertical incision going to the pectoralis majoris (in subjects with a strongly developed musculature this muscle is cut across, in women it is usually enough to move it downwards) the neurovascular bundle is reached and it is carefully taken away to the side. Then the anterior edge of the joint socket is found and an opening is made in its lower part, into which a bone pin taken from the tibia is inserted; if it seems necessary, the joint capsule is sutured with several stitches; then catgut stitches are placed on the muscle and aponeurosis and silk stitches on the skin, and a small swab is placed in the lower edge of the wound. The arm is bandaged to the torso.

The author suggests the following method of treatment: after a vertical incision running from the cranial process to the lower edge of the m. The author suggests the following method of treatment: after a vertical incision going to the pectoralis majoris (in subjects with a strongly developed musculature this muscle is cut across, in women it is usually enough to move it downwards) the neurovascular bundle is reached and it is carefully taken away to the side. Then the anterior edge of the joint socket is found and an opening is made in its lower part, into which a bone pin taken from the tibia is inserted; if it seems necessary, the joint capsule is sutured with several stitches; then catgut stitches are placed on the muscle and aponeurosis and silk stitches on the skin, and a small swab is placed in the lower edge of the wound. The arm is bandaged to the torso.

The author cites five cases of tabetic optic atrophy, which he treated partly specifically and with nucleic acid sodium, but mainly with injections of flogetan. All cases were followed up for 3-4 years.

In the blood of pregnant women circulate specific substances (antigen), which form antibodies against placental proteins, and there is a marked change in the electric charge of the antigen. On this basis, the author advises to prepare an alcoholic extract of placenta, add it to the serum under study and pass an electric current through the mixture, observing then under a microscope the movement of particles to the anode. Without the addition of serum, this rate is 3.2 µ, per second, with the addition of normal serum it is 2.2 µ, and with pregnant serum it is 1.0 µ per second. 

Based on 2000 deliveries with 150 narrow pelvis the author comes to the following conclusions: if the labor does not progress after 16 hours of labor and the total number of contractions up to 150, a caesarian section is definitely indicated; if the yawn is partially open and the water has broken away, you can wait up to 24 hours from the beginning of contractions and the total number of contractions is 220.

Radium may not be applicable in all cases of uterine cancer, and for these cases G. suggests treatment with acetone. These cases are: 1) patients with cutaneous cachexia, who are unable to tolerate the body's load of decay products in radium treatment; 2) patients with bladder and rectal lesions; and 3) cases with planar spread of cancer along the vaginal walls.

On the basis of a large, well-traced clinical material, the author concludes that the prognosis of renal diseases in childhood is much more favorable than in adults, since the replacement of diseased renal elements by newly formed cells occurs much easier here.

On the basis of 7 years of observation, the author finds that the results of inoculation of m. quartanae are no worse than those of three-day fever, and the whole treatment is, moreover, gentler, why it is recommended especially in weak patients.

Even in severe cases of hiccups the author obtained good results from smearing the nasal mucosa or spraying it with the following solution: Cocaini mur. et suprarenini aa 1.0, acid, carbol, liquefacti gtt. I, aquae dest. ad 50.0.

In an extensive lecture, Finger returns to the burning question of early syphilis therapy. Already the old syphilitic clinicians pointed out that mercury and iodine are not parasitocidal agents; the same applies to salvarsan, which even in strong concentrations (1:100) does not kill pale spirochaetes. Apparently, all our antiluetica act with the help of the body's natural defenses (recently, as we know, this role has been attributed to the reticulo-endothelial system.

The best remedies for this disease are, according to Unna, chaulmoogr oil and antileprol made of the latter. Antileprol can be administered to patients in large doses, from 6.0 to 8.0 every 3-5 days intravenously, and not only the external manifestations of the disease, but also the bacilli disappear.

Of 56 cases, Schaumann and Heden had complete success in 26, partial success in 21, only slight improvement in 7, failure in 2. Most patients do not tolerate the drug well - they have kidney disorders, erythema, stomatitis. For this reason, a very careful dosage of the drug is necessary.

The author cites a case of an ink pencil injury to the index finger of the left hand of a 27-year-old clerical worker. The finger swelled up, resulting in fever and headache. After cutting out the injured area with removal of the broken tip of the pencil, the wound became necrotic, cleared within 6 weeks, and only healed after 8 weeks.

In addition to the increasing exposure of the female body to fashion and the unhealthy sexual arousal associated with it, women's dresses are also greatly flawed against hygiene itself - in the sense of protection from dust and cold.

In the last 2-3 years, the activity of provincial medical publishing houses has been very lively. Regional and even provincial health departments have begun to publish not only popular pamphlets, but also solid works on various issues of medicine. In front of me lie two large collections, which are very characteristic, because they reflect all the features, advantages and disadvantages of the works of provincial authors, standing outside the universities. Therefore, I think they are worth talking about.

The autumn term of the new academic year began at the Kazan Institute for Usov. Physicians on 1/X. The Institute received more than 180 seconded doctors, mostly from rural areas, transport doctors, and city hospitals. This time the area from which the doctors came was much wider than before; especially many cadets arrived from the Caucasus, from Siberia, from the national republics of not only the Volga-Kama territory, but also from the most distant suburbs of the Union (Buryato-Mongolskaya, Uzbekistan).