Vol 35, No 2-3 (1939)

The experience of daily work and literature data show that when patients come to us with typical symptom complex of cholelithiasis, the cause of suffering is often only functional moments - stagnation and disturbance of bile movement on the basis of motor disorders of external biliary tracts. This form of the disease is known under the name of stone-free biliary colic or simple biliary colic, or, at last, according to the suggestion of Westphal, Kalk and Shendube-diskinesis of external biliary tracts. The knowledge of the pathophysiological bases of the disease we are interested in we owe to the capital works of the Pavlov's school (Babkin, Shaverin, Bykov's laboratory, Odinov, Petrovsky) and Bergman's school (Kalk and Shendube, Westphal) and to the successes in the field of X-ray diagnostics - introduction of cholecystography into the clinic of internal diseases (Graham, Kalk and Shendube, Boyden, Vitaker and Nelson, etc.).

For a long time a number of authors have noted changes in the digestive tract in diseases of the liver, gallbladder and biliary tract. For example, it is known that acute hepatitis is usually accompanied by dyspeptic phenomena. As for cholecystitis, the latter are very often observed phenomena of gastritis. A number of researchers (Bergman, Zimnitsky, Luria, etc.) have studied changes in the secretory function of the stomach in diseases of the liver and gallbladder. The data obtained were rather contradictory. For example, Luria, Zimnitsky, Myasnikov, Kovalenok and others indicate that cholecystopathy is always accompanied by a decrease in acidity and even complete achilia. This decrease in acidity, according to some, depends on the absorption of bile into the stomach, others see in it the influence of reflex inhibition of secretion by the sympathetic nervous system. Badylkes, on the basis of his experiments on dogs, believes that inflammatory processes in the gallbladder cause a slight decrease in the duration of bile secretion and a considerable decrease in secretion and acidity. Oli found a decrease in acidity in 45 of 87 cases. Gollweg, with 43 observations, found a deficiency of hydrochloric acid in 84%. Similar data have been obtained by Aldor, Gechtman, Bergman and others.

Walks with mountain climbing are an active tool in the treatment of obesity in Kislovodsk. This means more readily than others agree to use patients, often abusing it in an effort to maximize weight loss. While studying the effect of terrencourt on cardiovascular patients, we found some peculiarities of the response to terrencourt in obese. We made 62 observations in patients with initial cardiosclerosis, 64 in patients with mitral malformations and 34 in patients with obesity of exogenous origin. All patients had complete cardiac compensation.

In the study of water metabolism, the hydrophilia of tissues is of great importance both in physiological and pathological states of the organism. This side of the question can be studied in detail using the reaction of McClure and Aldrich.

To stop bleeding (pulmonary, uterine, etc.) there are a number of remedies that give good results. However, there are persistent and profuse bleedings in which these remedies have no effect. In such cases, I recommend trying subcutaneous injection of sulfuric acid atropine 0.0003-0.0005 and up to 0.001 pro dosi. To stop very persistent and severe bleeding, 1-2-3 injections are usually sufficient.

The erythrocyte sedimentation reaction (ESR) has become a really common reaction in pulmonary tuberculosis and is relatively widespread in acute rheumatism. However, in many other areas of internal medicine, the use of ESR is very limited. The main reason for this phenomenon should undoubtedly be considered insufficient study of ESR in various diseases and rather variegated and often divergent results of research obtained by individual authors.
Meanwhile, each method of research, which can give an objective idea of the patient's condition and the course of the disease, should be seriously studied.
Literature data on ESR in malaria are not particularly extensive and contradictory; this prompted us to study ESR and find out the value of this reaction in malaria.

Observing the ESR in typhoid fever patients, we wondered whether the ESR changes according to the severity of the disease, intoxication, complications, temperature, and the course of the disease in different periods.
We studied the erythrocyte sedimentation rate in 32 typhoid fever patients aged 12 to 43 years, at different stages of typhoid fever development, with different complications and different course in terms of disease severity. A total of 120 samples were taken, of which 4 patients were sampled twice, 14 patients were sampled three times, and 14 patients were sampled four or more times.

It is well known that early diagnosis of tuberculosis, as well as other diseases, provides an opportunity for effective treatment. In order to detect tuberculosis, the joint work of a general practitioner and a phthisiatrist in polyclinics, outpatient clinics and hospitals is of great importance.
From the point of view of differential diagnosis, the 95 case histories of persons transferred from the therapeutic and surgical hospitals to a tuberculosis hospital, of whom only three patients had been registered with the tuberculosis department before entering the therapeutic hospital, are of some interest.

In a polyclinic setting, it is difficult to find out how the Narzan baths and stay in Kislovodsk affect menstrual function, especially since the mechanism of ovarian-menstrual function itself is known to be quite complex.

The administration of mineral waters subcutaneously for the treatment of diseases of the female genital organs is worthy of particular attention. There are reports from French authors (Bilyar, Riche) and workers at Prof. Serdyukov's clinic that highly approve of the therapeutic effect of parenterally administered mineral waters in gynecological diseases. Furthermore, clinical observations were published in works by Gashon and Gordon.

Few authors have experience with blood transfusion in puerperal and gynecologic sepsis. Spasokukotsky, Ilkevich, Delma, Glauber, Haberland, Pieper, and others, who have obtained encouraging results, are proponents of blood transfusion in septic diseases. Many authors to date have been reticent about blood transfusion in sepsis. There is no consensus regarding the optimal timing of blood transfusion in sepsis. Some authors advocate for transfusion in the initial stages of sepsis, while others suggest a later approach. The majority of authors oppose transfusion in the advanced stages of sepsis, when the prognosis is poor.

In our clinic, we recently had a case of bone formation in the surgical scar at the site of an incision made along the midline of the upper abdomen. Almost along the entire length of the scar, a dense bone plate could be felt, which could be covered from all sides. Unfortunately, the patient did not undergo surgery, but the results of his examination left no doubt that there was bone formation.
In another case of a 26-year-old woman with malarial splenomegaly, when the spleen was removed in our clinic, a bone plate was found in its tissue, apparently formed at the site of a small rupture of the spleen in the past.
In the available literature, we could find a description of only five cases of calcifying periorchitis.

Frank first isolated essential thrombopenia as an independent disease from the group of hemorrhagic diatheses in 1915. Katznelson proposed the removal of the spleen in this disease, and the Prague surgeon Schlofer performed the first such procedure in 1916, achieving a notable outcome.
The question of the origin of thrombopenia remains unresolved. All investigators concur that removal of the spleen in thrombopenia yields excellent results. However, some of them posit that the spleen plays a role in cases of thrombopenia by producing a hormone that inhibits the formation of platelets in the bone marrow. Others hypothesize that the origin of thrombopenia is due to the spleen's excessive thrombolytic function. Consequently, there is a myelogenic and splenogenic theory of the origin of thrombopenia.

The phenomenon of vicarious bleeding is understood to be the bleeding from various parts of the body, mainly from the skin and mucous membranes, in connection with the menstrual function. As Professor Gruzdev points out, these bleeding episodes may occur either in the complete absence or cessation of normal menses. In some cases, they may even occur when the latter are preserved. In our case, bleeding from the rectum was observed. 

The uncertainty of the etiology of scaly skin disease represents a significant obstacle to the development of a valid, specific treatment for this chronic disease. The abundance of proposed remedies for the treatment of this disease demonstrates our collective helplessness in the fight against it. 

The TASHMI Clinic for Skin Diseases has observed a significant number of patients with psoriasis over the course of its operations. In the course of this observation, the clinic has attempted to employ various treatments that are currently recognized in modern medicine. However, some of these treatments have proven to be either entirely ineffective or to present considerable technical difficulties when applied outside of the clinical setting. These difficulties include, but are not limited to, treatments such as tar baths and ointment therapy.
In response to these observations, Professor A. I. Kartamyshev proposed a method of treating scaly plague by baths with hyposulphite.

On December 17-19, 1938, a conference on the problem of the genesis of old age and the prevention of premature aging of the organism was held in Kiev, organized by the Institute of Clinical Physiology of the Academy of Sciences of the Ukrainian SSR, the Institute of Experimental Biology and Pathology, and the Institute of Clinical Medicine of the People's Commissariat of Health of the Ukrainian SSR. The conference was attended by 378 participants.

The author describes 3 cases of tularemia following eating fish caught in a net with rabbit as bait. 

The author subjected 64 patients with pyelitis of pregnancy to treatment with sulfanilamide. Mild cases were treated in 4-5 days. Renal and toxic pyelitis required longer treatment /14 days/. Sulfanilachmide was much more effective than all previously used agents. 

The author used Prontosil (Winthropa) in 39 cases of postpartum sepsis caused by hemolytic streptococcus (Lancefield's group A), 35 cases of mastitis, and 8 cases of urinary tract infection with Escherichia coli. Of the 39 patients with puerperal sepsis, 27 had local uterine infection, 8 had generalized sepsis (two with peritonitis), and 4 had disseminated peritonitis. Prontosil was administered intramuscularly and intravenously. 

The author studied the distribution of Staphylococcus aureus in the body during intravenous injection of doses killing a rabbit in 20-24 hours. It turned out that at the beginning of the infection staphylococci are concentrated mainly in the spleen pulp and in the Kupffer cells of the liver. 

In the United States, Staphylococcus aureus is a common cause of food poisoning. Consequently, numerous authors have endeavored to investigate the distinctive characteristics of strains of this microbe that are capable of causing gastrointestinal irritation. The present study employed the Dolman, Wilson, and Cockcroft method for the detection of staphylococcal enterotoxin. This involved the intra-abdominal administration of the studied staphylococci to kittens. In addition to the aforementioned animal experiments, the study also encompassed the examination of the culture and biochemical properties of enterotoxic staphylococci.

The authors treated 118 gonorrhea patients with sulfanilamide. Only once was a severe adverse event (hepatitis) observed. Out of 50 women, 41 had a good outcome. In three cases there was a late relapse. Of 35 cases of complicated male gonorrhea, a favorable effect was observed in 29. 

Experiments on animals led the author to the following conclusions: absorption of uluron starts from the stomach. The amount of uluron absorbed from the stomach is different, more often very small. In the small intestines uluron is absorbed in significant amounts. 

The author cites 5 cases of polyneuritis due to uliron intake. All patients complained of calf pain and gait disturbance. All had absent reflexes from the Achilles tendons. No abnormalities of sensitivity and electrical reactivity were found. None of the patients showed any improvement during the entire observation period.