Vol 24, No 8 (1928)

Muscle movements are of great importance in the physiological processes of the body. Labor of a worker in a factory, work of a peasant in a field and at home, physical training, and often even different kinds of rest (hunting, boating, skiing, skating, etc.) are connected with more or less tense muscular movements. The study of the effect of the latter on the body is of multifaceted interest: on the one hand, it gives an opportunity to establish the impact of these movements on other physiological processes of the body, and on the other hand - a more objective approach to the scientific organization of labor and physical education. As in our clinic the questions of blood formation and morphological composition of blood are given very significant attention, we used the opportunity to make observations of changes in the morphological composition of blood under the influence of muscular movements.

The world literature counts not more than 4 - 5 hundreds of mesenteric tumors of different character, most of them are cystic and only about one fourth of them are dense tumors. According to Popov's statistics (from the clinic of Prof. Fedorov) the latter have been published in 134 cases only, including malignant tumors in 75 cases, namely sarcomas in 69 cases and cancers in 6 cases. Among benign tumors, fibromas (28 cases), adenomyomas and neuromas (1 case each) are more common here.

Several thousand years have passed since the abdominal caesarian operation, known as far back as the ancient Egyptians and included in the legislation of the Romans of the time of kings, began to be used on the dead. More than 300 years have passed since Trautmann, in Wittenberg, first successfully performed it on the living (in 1610). Finally, several decades have passed since when, thanks to the successes of antiseptics and asepsis, this operation, like many others, from almost absolutely lethal has become relatively safe for the mother. Under such conditions and with the truly colossal literature on the question of caesarian section - it would seem that this issue should have long been resolved in every detail, and in it now can not be introduced any more or less major innovations.
However, this is far from being the case: in fact, it is in recent times, over the last 10 to 15 years, that we have found a number of significant changes in this area. One of these changes concerns the scope of the caesarean section and the indications for it. This change is directly related to the outcomes of the operation, both for the fetus and especially for the mother.

According to the majority of gynecologists, the operation of forming an artificial vagina is now out of the period of discussion of its ethical acceptability. It is true that even now some authors do not recognize its advisability, but they are a significant minority, and statistics currently counting hundreds of such operations with good, in functional terms, results give this operation, with special indications, the full right of citizenship.

The characteristic usually given for cerebral paralysis of facial nerve - affection only of its lower branches and very small participation of the upper branch, explained by Dejerine's bilateral supranuclear innervation of the latter, as more detailed researches of patients show, cannot be considered absolutely true. There are cases presenting retreats where both branches are involved in the lesion. Such cases have given rise to the assumption that the central conductors for the superior branch of n. facialis all the way from the cortex to the nucleus in the brainstem are separated from the conductors for the lower branches.

Recently after our articles "Paris greens as a means of struggle against larvae of malarial mosquitoes" and "Parisergrün als Anopheles-Larvizid" there appeared 2 articles on the same subject by F. I. Yatsenko, in which the author, considering his experiments in laboratory and natural conditions quite convincing, advises to use Parisergrün instead of oil and kerosene on huge areas (calculations are made on tens!) and suggests that Parisergrün promises to displace all other larvicides. In view of the fact that our experiments published earlier as well as those which we made further do not give us the right to consider Paris greens as an excellent larvicide, we will dwell first on Yatsenko's experiments to clarify whether they really allow to draw conclusions about superiority of greens over kerosene and oil and then we will pass to description of our new experiments which did not give a difference with the previous ones.

In the last 3 - 4 years, the theory of Professor of Kazan Veterinary Institute M.G. Tushnov has been attracting attention. Tushnov about excitatory action on vital activity of organs and tissues of protein products of decay of the same organs and tissues. This doctrine was formulated quite recently - in the February book of the "Kazan Medical Journal" of this year, when sufficiently accumulated material allowed Prof. Tushnov to rely on it.
In view of the fact that the doctrine of Prof. Miyagawa represents a theory almost coinciding with the doctrine of Prof. Tushnov, it is interesting to get acquainted with it - especially since the experimental direction, which Miyagawa gave his thought, somewhat differs from the direction of Tushnov, starting from the same starting point, both authors then diverge under the angle, and one (Tushnov) mainly goes further on physiological line, another (Miuagawa) - mainly on pathological one.

The posterior pituitary lobe normally consists not only of nervous tissue, but also contains at all ages glandular components. In children under 4 years of age, we find here abundant tubular branching glands lying usually in the anterior and lateral segments of the posterior lobe, as well as in the vicinity of the pituitary stalk. The cells of the glands contain colloidal masses showing the same attitude to dyes as those in the conduit passages and formations lying between the anterior and posterior lobes of the pituitary gland.

Observations convinced the author that monocytes can be vectors of a problematic tumor agent. He found that monocytes alone, extracted from the blood of diseased chickens, were sufficient for successful transfer of chicken sarcoma.

In the author's opinion skin and tongue keloidosis, chalikosis and antrakochalikosis of lungs and callous ulcer of stomach are manifestations of the same peculiar connective tissue disease, to which S. gives the name of keloidosis. The essence of this disease consists in development of granulation tissue rich in fibroblasts, but poor in blood vessels, which then forms hyaline nodules ("nodose keloidosis"), or hyaline bands ("diffuse keloidosis"). The cause of keloidosis lies in any irritations of the physical and chemical nature; but in addition to this a congenital predisposition of the connective tissue is also necessary for the development of this disease.

The authors applied in 20 rusty patients prickings with antivirus in the following form: a solution of Bezredek antivirus was sterilely filled into a 1-g syringe and a thin needle was injected at a distance of 8-10 centimeters from the edge of the rust process in an amount of 0.1 cc intradermal - until a small white papule appeared, ¹/₂ - centimeter in diameter; such injections were made around the whole rust affected place, at a distance of 1 centimeter from each other. In 15 cases the local process was abruptly interrupted by such treatment, the redness did not go beyond the line of injections, the temperature dropped the next day, and the general condition improved. Only in cases of septic rye did antiviral injections prove to be ineffective.

The primary tbc lesion is localized mostly in the lungs, but not in the apices, as it was thought before, but in the marginal parts of the middle and lower lung fields. From here the infection spreads to the regional glands, and these glandular foci instead of the primary foci in the lungs form the so-called primary complex, which we still clinically are not able to recognize. With further spread of the process there comes a period of generalization: spreading along the lymphatic tracts, the infection affects distant glands, enters the blood and gives gematogenous metastases in various organs.

Despite a well-developed clinic of artificial pneumothorax, we still do not have a definite and unanimous opinion on the duration of gas bladder maintenance. Meanwhile, this issue is extremely important, because the lung parenchyma suffers from prolonged compression.

The authors were convinced that slow injection of 70-100 cbm of normal or ¹/₃-normal solution, phosphate (13.5% NaH₂P0₄, or 11.9, or 35.8% Na₂HPO₄) into a vein acts favorably in this symptom complex (10 in 11 cases). Especially in case of cerebral basis of disorder by this method it is possible to cut it off for 1-4 hours. The active ingredient here is the phosphoric acid ion. At the same time it is necessary to take measures against cardiac weakness.

One of the best ways to treat this disease the author considers X-rays. It would, however, be a mistake to think that all other therapies are excluded in this case - along with roentgenization, surgical treatment retains its raison d'êetre. Since tbc, then, is usually not only a local disease, but also a general disease, methods aimed at the general strengthening of the whole organism must be applied here as well.

Comparative measurements of blood pressure by oscillatory, auscultatory and palpatory methods made by the author on 37 patients led the author to conclude that the blood pressure measured by oscillatory method is 84% higher than the blood pressure in the same individuals measured by the other two methods, and that in 43% the blood pressure measured by auscultatory method is higher than the blood pressure in the same individuals measured by palpatory method.

The author considers pyrosis hydrochlorica as the most frequent form, although there are cases of heartburn with reduction, even complete absence of HCl in gastric juice. However, strong acidic juice itself does not yet give chronic heartburn - this requires irritation of the cardiae or lower parts of the esophagus. Therapeutically you have to fight against increased acidity in most cases, first of all with dairy and vegetable food; long term giving of alkalis, on the contrary, is less rational, although you can do without them not always. Symptomatic against heartburn is a mixture of sweet and bitter almonds (3:1) in the form of fine powder, or almond milk.

The author considers Staphylococcus as the most frequent causative agent of this disease, Streptococcus occurs much less frequently, and other microbes occur only in exceptional cases. The predisposing moments here are often trauma and infection. The bone marrow is usually infected by blood, but this is not the case, but for the bones the haematogenous route of infection is the rule. The germs originate either from some nest of infection or from the skin and mucous membranes; in this case the infection can remain hidden in the body for longer than is usually thought. Antigen therapy appears here to be scientifically quite reasonable.

Steinert was convinced that the named reaction not only reveals amyloid degeneration, as such, but also indicates sensitization of the organism to the leukocyte protein and thus the danger of later development of amyloid. Its positive result obliges, in light chronic suppurations with good general condition of patients, to long-term and possibly non-stop removal of pus.

О. Kraus, being negative to all types of local treatment of rye, praises intramuscular injections of milk (5 cс), deflowered for 10 minutes in a water bath. Already on the 2nd-3rd day of the disease the temperature drops critically or lytically with such treatment, at the same time swelling and redness disappear. Appropriate amounts of anti-diphtheria serum, as the author has seen, are not so favorable. Contraindications to the treatment of rust with milk are pulmonary consumption and recurrent hemorrhages in the stomach.

К. Boshamer deduces from his studies that every ether anesthesia gives a small damage to the liver, which is made very noticeable if the organ has been previously diseased, even if it is latent. Such latent damage to the liver occurs in chronic gallbladder disease, alcoholism, chronic pancreatitis, cancer and chronic diseases. In such cases the named anesthesia should be especially avoided.

Lissmann, after encountering in practice the question about preservation of sexual ability during prostatectomy and not finding an answer to it in the relevant literature, addressed a questionnaire on the subject to 220 urologists and surgeons in Europe and America. After processing the 100 responses, he came to the following conclusions: 1) Libido and functio erigendi are probably not affected by the so-called transmucosal prostatectomy and may even occasionally increase and, if they subside, reappear. 2) The preservation of the potentia generandi depends on the extent to which the genital parts of the posterior urethra are spared during the operation, which is undoubtedly possible. 3) Ejaculation may be destroyed by the operation.

H. Vignes finds that lead-poisoned women often abort or give birth to dead children, and their living children usually die in the first years of life; this rule, however, may allow for exceptions. Therefore the author does not need, furthermore, that women with an abnormal course of pregnancy on account of lead poisoning present severe signs of the latter: sometimes abortions are their only symptom of saturnism.

Fever during labor, depending on the upward spread of infection through the genital canal, should not, according to Siegert, be an indication for operations aimed at hastening the termination of labor: observations show that the use of such operations leads to increased morbidity in the puerperal period. In such cases, it is only necessary to resort to labor-saving operations when there is no hope of spontaneous termination of labor.

Dr. Stimson, in an article on the early diagnosis of measles, points out that most of the known symptoms of the prodromal period, such as exanthema, corneal spots, prodromal rash, etc., appear when the catarrh of the nasal and pharyngeal mucosa is already clearly expressed and when, therefore, the patient has already managed to infect the surrounding children. Therefore the symptom described by the author, which appears about 11 days after infection, even before the appearance of the catarrh, namely about 12 hours after the first rise in body temperature, is of great importance.

The authors in 13 cases of moderate to severe rickets gave the patients daily 300-500 cc of milk subjected to roentgenization in an atmosphere of carbonic acid. All the patients recovered within 4 to 6 weeks.

Saudek recommends that for the treatment of chronic urethritis in men and women use kelp sticks previously dipped in liquefied gelatin containing either 0.1-0.5% lapis, or 1-3% sulfuric zinc, or 1-3% copper sulfate. For men take sticks of 10 centimeters. length, for women - 3-4 centimeters. Leave them for 2-3 hours. Chronic cervicitis can also be treated with these sticks.

Mityukevich convinced that the best medium for growing gonococci is made from fresh, never sterilized before meat water and martin peptone: this environment is added (by Ikoma) citric acid in the amount necessary to lower the Ph from 8.0 to 7.8, the mixture is sterilized at 115 ° in a 20-30 minute, and 10% ascitic fluid is added to it, the suitability of which for this purpose has been verified by preliminary experiments; to obtain solid media, 1.7% agar is added to the broth. The best growth of gonococci on this medium is obtained at 36°.

Dahschleiter dedicates his work to the diagnosis of gonorrhea in girls. If there is no consensus on the practical value of bacteriological examination of genital secretions for suspected gonorrhea in adult women, there is even more difficulty in determining the nature of vulvitis and vaginitis, on the basis of bacteriological examination, in girls. The author dwells on the question, which attracts the attention of venereologists and urologists, of the importance of Gram-negative diplococci and the so-called Asch's diplococci in the recognition of gonorrhea.

The author considers Viktoriablau dye particularly suitable for this purpose. A small amount of sap is scraped off the edge of the shanker ulcer on a clean slide, the smear is air-dried, and a 3% aqueous solution of Grübler's Viktroriablau is dripped on it. The solution is left for 2-3 minutes, then washed off with tap water, the preparation is dried and examined under immersion, and the pale spirochaetes appear to be stained a thick blue color, distinguishing them sharply from other spirochaetes. Being preserved in a dark glass vial, the dye solution can be preserved unchanged for a long time.

Р. Sauer describes an abscess in the temporal lobe of the brain that developed acutely on the basis of otitis acuta. The patient was under observation from the very beginning of the ear disease, so that she could trace the entire disease process from the beginning to the end. Noteworthy in this case is the absence of changes in the bone, which changes are almost always found in the middle ear and proc, mastoideus in those cases where the formation of a cerebral abscess occurs.

Khristianov collected statistical material concerning malignant tumors of the nose. From the latter it is clear that sarcomas account for very few cases, with gigantocellular sarcoma occurring as unicum. It has an extremely" rapid growth, is constantly recurrent, but causes neither pain nor cachexia. The author cites two own cases of this neoplasm.

The book is written by a great connoisseur of renal pathology. Being himself one of the founders of the modern doctrine of functional diagnostics of the kidneys - recalling his exceptional value of the study of renal function in experimental nephritis - Professor S., naturally, in his book, focuses on the importance for the doctor of studying the function of the diseased organ, without touching the pathological and anatomical side of the issue and deliberately not stopping on controversial theoretical problems. The purpose of the book is purely practical, to give a clear and concise statement of the current state of the teachings on renal diseases and to formulate precisely, concretely the necessary and at the same time only reliable therapeutic measures.

The congress was held in Moscow from May 26 to 30, 1928. The number of its members exceeded 1,000, of whom 50% were from the provinces. During the four days of the meeting more than 60 reports were presented, the fourth day being devoted exclusively to orthopedics. Prof. V. A. Oppel was elected chairman of the Council and Prof. H. I. Keffer, orthopedist from Odessa, as comrade chairman. The program questions of the S'ezd were: 1) the question of uronephrosis and 2) the question of perforative gastric and 12 duodenal ulcer. Then there were several recommended topics: cancer of the tongue and its treatment, treatment of contractures and ankylosis of the knee joint, and intra-abdominal strictures and their treatment. In addition, there were several presentations on extracurricular issues. The program of the Congress was fulfilled in its entirety within the prescribed time frame. The chairman of the S'ezd, Prof. Oppel, quite objectively summarized the data of the reports and debates, which greatly enhanced the impression.

Prof. I.I. Vasiliev made a report on a rare case of non-erupture of the Botall's duct and simultaneous acute endo-arteritis of the aorta and the pulmonary artery. - This report, accompanied by demonstration of preparations, provoked questions and comments from Dr. R.Y. Gasul and prof. M. N. Cheboksarov and N. K. Goryaev.
Dr. A.V. Golyaev made a report: "Free fibrinous bodies in pleural cavity". This report will be printed in full in "Kazan Med. Journal". - Dr. R.Y. Gasul, Prof. I.N. Vasiliev and Dr. Zakharov, who noted that in this case the presence of air in pleural cavity and increased Ca content in body juices (the patient had spontaneous pneumothorax and was treated with Ca) may have played a role in occurrence of fibrinous bodies in pleural cavity.

The Center resolved the issue of building new clinics in Kazan for the Institute for advanced training of physicians. For the construction of clinics the Center has allocated two million rubles for 5 years. These funds will be used to construct three large buildings with equipment meeting the latest technological and medical requirements. Under the construction of clinics City Council has allocated part of the quarter number 77 - between the Clinical Institute and the Palace of Labor. A park will be laid out near newly built clinics. The construction will begin in the next construction season.

What books can be recommended on the question of exudative diathesis and its manifestations in childhood?

Answer: I recommend the book by Prof. Maslov "The Study of Constitutions and Abnormalities of Constitutions in Childhood, 1925, and the book by Engel "Constitutional Anomalies and Metabolic Diseases," 1927.

Prof. V. Menshikov.