Vol 34, No 10 (1938)

By the 20th anniversary of Soviet medicine, which was celebrated in 1938, the health care of our country was enriched with documents of the greatest political and organizational significance. First of all, this is the decree of the Council of People's Commissars of the USSR of 23/1V 1938 "On strengthening the rural medical area", reflecting the Stalinist concern of the party and government to improve medical care and a serious rise in sanitary affairs in rural areas of the multinational Soviet Union. Guided by the decree of the Council of People's Commissars of the USSR, the People's Commissariat for Health developed the "Regulations on the rural medical area", constituting health care in the countryside in the entirety of its new tasks and new ways of working.

Chromoscopy as a diagnostic method for violations of the secretory function of the stomach was introduced into the clinic almost simultaneously by the Austrian doctors Saxl and Scherf and the Germanic Glessner and Wittgenstein in 1925, but since Saxl and Scherf, although they were the first to publish their method, they worked with an insufficiently suitable indicator (methylene blue) and appeared in the less widespread press, and Glessner and Wittgenstein used a more successful neutralroth paint and published the method in the leading German press, then they remained priority in this matter. The results of their observation are as follows: neutralrot is not salivated, in a normal stomach it is shown after 15 minutes, with subacid values ​​of gastric secretion, the coloring matter is released after 20-60 minutes, and with anacid secretion it is not released at all.

As you know, polyserositis is understood as a systemic lesion of the serous membranes, mostly by chronic inflammation, and the serous integuments of the pleural, cardiac and abdominal cavities are affected simultaneously or sequentially in various combinations.

Our data from the experimental study of BCG with the introduction of a live culture into the submucosa of the tongue confirmed the main provisions of Calmette and boil down to the following: at different intervals from the onset of infection, foci appear at the injection site of various shapes and sizes; the foci do not reach decay and ulceration at the injection site. The appearance of the lesion resembles an abscess infiltrate. The corresponding regional lymph nodes are not reactively involved in inflammation. The mucous membrane surrounding the focus remains without visible changes.

In this article, I mean once again to draw attention to the method of collecting those facts that are obtained by the so-called subjective research, that is, by questioning the patient.

The fact that infection plays a role in the onset of pneumonia does not raise doubts at present. The importance of allergies in this disease, it seems to us, should also be considered proven. Even Wolf-Eisner considered the crisis in pneumonia as a phenomenon of anaphylactic shock based on leukopenia, a drop in temperature, and a decrease in blood complement. A number of facts speak in favor of the allergic theory of pneumonia: the violent reaction of the body at the onset of the disease, the rapid development of all pathological phenomena, the rapid coverage of the large anatomical units of the organ by the process, the fibrinous and hemorrhagic nature of the effusion itself, indicating the rapid onset of deep changes in the vascular walls (Davydovsky), herpes - expression on the skin of an increased sensitivity of the body to pneumococcal toxin (Konchalovsky), a tendency to relapse. The causative agents of pneumonia — pneumococci — are often found in the upper respiratory tract in healthy people and, therefore, sensitization of the body is quite possible. Children in the first months of life rarely get sick with pneumonia and very rarely give a positive skin reaction with pneumococcus, which can be explained by the lack of sensitization. The observed diseases of newborns, whose mother had pneumonia during pregnancy, can be explained by intrauterine passive sensitization, as a result of which the child is born with increased sensitivity to pneumococcus (Lauhe). Sirotinin believes that in the etiology of pneumonia “the predisposition associated with the constitution, generally characterized by a tendency to inflammatory processes (weakness of the active mesenchyme according to Bogomolets), is of great importance in the etiology of pneumonia, which is one of the distinguishing features of the allergic constitution”.

Phosphatase is an enzyme that cleaves inorganic phosphorus from its organic compounds. The presence of phosphatase has been found in a number of different organs, in the kidneys, liver, bones, serum, etc.

The main source of infection with dysentery is sick and recovering people. In patients, the process can proceed in an acute or chronic form. Through their feces, these persons infect the environment, edible products (especially water consumed raw, flies. Acute dysentery patients, chronic and convalescent patients cause the appearance of healthy carriers - carriers of infection.

In the periodical literature over the past 10 years, there is a very small number of works devoted to the issue of the provocation of malaria by surgical trauma, although surgeons, who are often forced to operate on malaria, must have faced a similar postoperative complication. This issue we have in the Volga region and in particular in the Saratov region, where malaria occurs, should be of great importance and requires special attention. Our clinic studied the impact of surgical trauma on the provocation of malaria during 1936 and 1937.

Injuries to the thoracic duct during neck surgery are rare.

But recently, due to the expansion of indications for operations to remove malignant tumors of the supraclavicular lymphatic glands of the neck, cases of injury to the thoracic duct tend to slightly increase.

Frequently occurring cases of stenosis of the birth canal are formed in adult women, according to most authors, as a result of traumatic or inflammatory processes in this area.

The issue of ileus in obstetrics is little covered in the literature. In the manuals for obstetrics, we found brief indications of this complication only in Gruzdev, Hunter and Stäckel. In 1928 Rusin collected 13 cases from Russian literature, Krupsky and Savitsky collected 30 cases in 1933. In foreign literature, we find the works of Van der Geven (1914 - 94 pages), Leitner (from 1914 to 1925 he collected 81 cases), Preuss (world statistics until 1933 in 250 cases).

Over the past five to six years, a new chemotherapeutic drug — streptocid — prontosil — rubiazol — has attracted the attention of doctors of various specialties. This drug was first discovered by Klarer and Mitch in 1932 in Germany and named by them "prontosil". In our Union, the same drug was synthesized by Magidson and Rubtsov in 1935 at the Research Chemical-Pharmaceutical Institute in Moscow and received the name “streptocide” (p.). In France, an identical drug was obtained by Girard and named by him "rubiazole". Later, this first drug was called red s., Since new modifications of s. Were proposed that have different physicochemical properties (soluble s., White s.,).

Patient S-ch, 40 years old, was admitted with complaints of shortness of breath, severe pain in the left side of the chest and in the left hypochondrium and inability to lie on the right side and back. 5 days ago b-noi received a knife wound in the upper left part of the back, between the scapula and 2-3 thoracic vertebrae. 10-15 minutes after the wound, the b-mu was helped by a surgeon, who ascertained that the patient had a wound penetrating the pleura and lung with symptoms of subcutaneous emphysema, there was no hemoptysis. Gd had a very bad night, restless and anxious and complained of pain in the left side of his chest. In the morning, a council of physicians and surgeons established hemopneumothorax in b-th. The temperature was normal; on the back between the left shoulder blade and the second thoracic vertebra, a small wound was found with a small amount of blood discharge. In the following days, the patient's condition worsened, shortness of breath increased, insomnia, a feeling of compression and pain in the left side of the chest increased, the temperature rose to 37.4 ° and on the advice of the doctors who used the patient was hospitalized with a diagnosis of hemopneumothorax.

Patient B.K., doctor, 35 years old, 15 / X 30, suddenly felt acute abdominal pain. In the morning, the patient took part in unloading potatoes, carried sacks. While working, he suddenly felt severe abdominal pain, went home and took to bed. At home, the pain did not stop, despite the rest and the heating pad put on his stomach. At about four o'clock in the afternoon, the patient sent for me.

Among the numerous complications of scarlet fever, bleeding from the cervical vessels is a relatively rare, but very dangerous complication. In an exemplary children's hospital, at 1370 scarlet fever autopsies, there were 12 cases of vascular bleeding from the neck, which is 0.88%.

The author describes a method for obtaining pneumococcal toxin under aerobic conditions on ordinary veal broth with the addition of 0.1% of human blood. The author managed to concentrate this toxin by precipitating it with ammonium sulfate and to obtain a skin reaction similar to that of scarlet fever.

A number of studies in recent years have shown that the division of meningococcus into 4 serological types, given by Gordon, does not cover all representatives of this microbe.

The outbreak of the epidemic that took place in New Nork in 1935 is characterized by the author as poliomyelitis, since the presence of flaccid paralysis occurred in about half of the cases.

The author investigated the healing results of large brain defects in dogs.

The author points out that after radiotherapy for cancer of the uterus, vaginal-rectal fistulas with corpuscular edges are formed. Closing such fistulas is difficult.

The author claims that lichen rosacea is caused by a fungus (Cryptococcus Duboisii).

The authors believe that the main cause of baldness is vasoconstriction caused by a violation of the innervation of the sympathetic nerve; there is a narrowing of vasomotors on the surface of bald skin foci.

In the Mayo Clinic dermatology since 1933, 35 large with miliary necrotizing acne have been registered - on the head.

The speaker demonstrates the patient S-va, 31, operated on (prefecture GM Novikov) in the emergency surgery for the weather of nodulation. The operations were performed under local infiltration anesthesia according to Vishnevsky. Removed 432 cm of small and 75 cm of large intestines (sigma), gangrenous intestines.