This February marks a quarter of a century since the death of Vyacheslav Avksentievich Manassein, a man who was "the living conscience of a Russian doctor" during his lifetime. The tremendous experiences that took place after the death of V. A-cha blocked his bright image from the eyes of the modern generation of Russian doctors. Now that our life has entered a calmer channel, the editors of the Kazan Medical Journal consider it their duty to remind fellow doctors about this true “teacher of life” and his precepts, especially since V. Ah was a Kazan by origin, and the editor of the Journal had the good fortune to be one of - alas! - the few who survived, his direct disciples.
February 13 Art. Art. 1926 will mark 25 years since the great doctor-teacher of life Vyacheslav Avksentievich Manassein left us, and all the good things associated with this dear name vividly rises before our eyes. The past 25th anniversary, outstanding for its grandiose events in Russian life, will forever remain memorable in the history of the country; but it overshadowed by its magnitude much that had happened before these years, including the glorious life and the charming figure of the doctor-teacher, who played a certain role in the preparation of the events experienced. The duty of us, who had the unforgettable happiness of learning from Vyacheslav Avksentievich, is to revive in the memory of contemporaries and give young doctors at least a faint sketch of who was and what the “clergyman of the secular church”, a true teacher of life and friend of the disadvantaged, was doing. His life was unusually modest and simple, without any loud and brilliant speeches and events, proceeding in tireless work and care for others; but, as a true teacher of life, V.A. can stand next to two outstanding Russian doctors: N.I. Pirogov and S.P. Botkin.
I first met V.A. in 1881, when I transferred from Moscow University to the third year of the Military Medical Academy. and V.A. taught us a course in private pathology and therapy, and in the evenings he went to the clinic every day with curators. Manassein's lectures were unusually lively. Possessing great erudition, constantly enriching his knowledge with the tireless study of current medical literature, he was a walking encyclopedia. His memory was amazing, but he still did not trust her and brought a pile of books to the lecture to acquaint us with the latest acquisitions from the original source.
My memories date back to 1884, when I lived in St. Petersburg and worked (preparing a thesis) in the laboratory of prof. NP Ivanovsky at the Military Medical Academy. Bykov was then the head of the Academy, prof. N.P. Dobroslavin. The central figures in the professorship of the Academy were S. P. Botkin, V. L. Gruber, V. V. Pashutin, K. F. Slavyansky and V. A. Manassein.
I greet you, comrades, on a major, great turning point in your academic life. In the first two courses, you were introduced to the preparatory sciences for medicine like physics, chemistry, anatomy, physiology. Then last year, in the third year, you already penetrated, so to speak, on the eve of medicine proper - you stocked up on information on general and specific pathology, diagnostics, pharmacology, etc.
One of the main works of my late teacher, Professor V.A.Manassein, relates to the study of changes in blood during experimental fever. The data of this work are still cited in monographs on this issue. Vyacheslav Avksentievich, one of the first Russian doctors, worked on the study of morphological changes in blood in various pathological conditions and, sending me to work abroad, he strongly recommended that I pay special attention to this department of pathology and the clinic. Wishing to mark the memory of my teacher in some way, I allow myself in this small work to report the results of my clinic's research on the morphology of blood in cardiac patients during the period of disturbance of the compensation of cardiac activity.
Lipemia, or excess fat in the blood, is a very common thing and shares the fate of many common things in a respect that has been very poorly studied.
Probably, every doctor more than once in his time heard the instructions of professors about the need for a broad individualization of treatment. As a student of the unforgettable Vyacheslav Avksentievich Manassein, I especially remember his inspired words about the destructive harm of a template in this area. And indeed, summing up your own observations, you involuntarily come to the same conclusion that templates and schemes harm both the patients who are used and the doctor himself, whose thought ceases to be free and creative and gradually learns to fit into previously prepared forms, trying to drive away painful doubts and work in a light atmosphere of pre-drawn diagrams, in conditions of least resistance.
I think that no one will dispute the benefits of bloodless repositioning of chronic dislocations in comparison with the surgical method of their treatment. The fact that many different methods are proposed for bloody treatment, and each author defends the advantages of his own method, speaks for the fact that treatment with a knife has significant disadvantages.
In 1908, I described a case of spontaneous intraperitoneal rupture of the bladder. Since then, in Russian literature, I have come across only one article by Belitsky devoted to this issue. In this detailed article Belitsky describes a case of intraperitoneal rupture of the bladder, operated back in 1909 by prof. I. A. Praksin, and reports statistics of both Russian authors - including my case - and foreign ones. From the data of Naumann cited by him in the article, it is clear that in the Salgram clinic for 12 years, for 20 thousand patients, bladder ruptures were observed only in 3 cases - in 2 intraperitoneal and in 1 extraperitoneal; Rokitsky for 15 years gives 12 cases, among which in 8 there was an intraperitoneal rupture and in 4 extraperitoneal rupture.
The World War and the revolution that followed it brought not only a lot of new things into social and personal life, especially in Russia, but they fundamentally disrupted the old way of life. The time we are experiencing has affected all aspects of our life, and, unfortunately, significantly increased the pathological processes in it. This opened up a wide scope for medical practice. Epidemics, many new diseases, an increase in morbidity in general, etc. - should have attracted the attention of doctors of all specialties. No less than others, obstetricians and gynecologists were interested in this, because the life changes associated with the war and the revolution affected not only the male, but also the female half of our population.
The complete absence of internal genital organs in a woman is not so rare in practice, and enough cases with aplasia of the vagina and uterus are described in the literature. It is usually indicated that, in the case of sexual activity, coitus often occurs in the dilated urethra.
While primary peritoneal pregnancy is the greatest rarity, and even the very possibility of it is rejected by some authors, secondary peritoneal pregnancy is known to be observed quite often. However, cases of full-term pregnancies of this kind do not occur so often, which prompts me to describe one such case that I operated on.
The extremely rich literature of childhood syphilis is devoted mainly to congenital syphilis. The literature of acquired childhood syphilis is relatively poor, which is quite understandable if we recall, first, that acquired childhood syphilis is immeasurably less common than hereditary, and secondly, that in its clinical manifestations it does not differ at all from adult syphilis. That is why, when describing acquired childhood syphilis, the center of attention is not so much the picture of the disease itself, but the etiological moments, ways and methods of infection.
In No. 12 of the "Medical Newspaper" for the expired 1925, in the chronicle section, a note was published. This note testifies that the question posed in the title of this article is really ripe for us and urgently requires one or another resolution.
The classic studies of R. Koch'a showed for the first time that an organism infected with tbc reacts in a completely different way to the introduction of tbc cultures and various cultures derived from them. drugs than a normal animal that has not yet had a chance to get acquainted with the tbc antigen. Koch's main experiments boil down to the following: if you inject a healthy guinea pig with a pure culture of tbc rods, then, as a rule, the wound at the site of the injection heals up and seems to heal in the first days: however, then, within 10-14 days, a solid a nodule that soon opens and forms a place ulcerating until the death of the animal; at the same time, swelling of the nearest lymph glands develops, and later the generalization of the process occurs.
If the doctors of the capitals and large provincial centers have the opportunity, at least from the periodical foreign literature they receive, to get acquainted with the achievements of surgery in Germany and other countries, then the workers of the deep Russian province are deprived of this opportunity either. In most cases, they are forced to be content with only brief abstracts published in the domestic periodicals. This explains the aspirations and interest with which I went to Germany at the first opportunity.
In contrast to the data of Steudel'ya M. Ya. Kalf-Calif (Doctor. Delo, 1925, No. 21) in his experiments found that there is no definite relationship between the intensity of putrefactive fermentation processes in the intestine and the release of uric acid.
The phenomenon of the often occurring coexistence of renal and gallbladder lithiasis, which has long been known to clinicians, prompted Chauifard and Debray (Presse med., 1925, No. 9) to investigate the question of whether there is a relationship between them.
The effect of calcium-containing dust on the lungs has been assessed by many authors as beneficial, or at least harmless.
Ya. L. Povolotskaya (Tr. I S'ezda Khir. Lev. Ukr., 1925) ardently speaks out in favor of such a method, which presents a number of advantages over the use of the bandage. The surrounding burned area and the burned surfaces themselves are washed several times with alcohol, the bubbles are opened at the base, the hanging scraps of burned tissue are cut off, the undamaged tissue around the burn bridge is smeared with some indifferent ointment, for example. Vaseline, in case of need, the wound is protected from dust, flies, etc. - and this is the end of it. In the future, all care consists in daily cleansing of the healthy skin surrounding the burn with alcohol and lubrication with an indifferent ointment, while the doctor does not touch the wound itself.
Martin (Zentr. F. Chir., 1925, no. 40) completely reject the reasons that, according to many authors, are responsible for the origin of gastroptosis, for example, corded liver, wearing corsets and a saggy belly.
Among the major disadvantages of the operation of denudation of the vascular wall according to Eeriehe'y are: 1) the thinning of the vascular wall caused by the operation with a violation of its nutrition, which can lead to sequential rupture and profuse bleeding; 2) compression of the vascular trunk by scar tissue with impaired peripheral circulation and the return of those phenomena for the elimination of which the operation is undertaken.
Bliedung (Dent. Med. Woch., 1925, No. 27) recommends instead of the proposed Zur Nedden suction of the vitreous body and its replacement, according to Elschnig, NaCl for a simple posterior sclerotomy.
According to Lanz's studies (Zeit f. Geb. u. Gyn., Bd. LXXX1X, H. I) already in quite healthy women, changes in metabolism can be noticed in connection with menstruation, these changes are especially pronounced in sick women, although - in those with mild diseases, what are the initial stages of tbc, disorders of internal secretion and autonomic nervous system.
Rösch (Münch, med ....) recommends for this purpose to inject into the posterior fornix, through qi (....) boric acid powder in an amount of 0.5: this is introduced first daily, then every 2-3 days. If after 2-3 weeks. pain with such treatment will not go away, which means that they are not of sleeve origin.
It is still unclear whether the causative agents of both of these diseases are identical or different. Lipschutz (Arch. F. Derm. U. Sypb., 1925, Bd. 149) indicates the difference between them on the basis of: 1) his own observations during experimental infection of human skin with a virus of both forms: 2) different duration of evolution of keratitis in a rabbit after vaccination of both viruses and 3) is different in histological skin lesions. A comparison of a number of clinical observations also indicates a difference in the etiological moment for both herpes species.
This book is a well-published collection of works by prof. Oppel, in which, according to his assistant, pr. Lisitsyn, broadly biological approaches to the study of surgical patients and to the study of endocrinological formulas in various diseases are expressed. Of the 25 original works included in the collection, 15 are devoted to the study of the issue of gangraena spontanea in connection with Oppel's famous theory of this disease.
This monograph provides a lot of valuable material. First of all, in it we find about 4000 X-ray studies related to various sports: swimming, rowing, fencing, boxing, weightlifting and athletics, etc.
Society of Physicians at Kazan University.
Ophthalmological section.
On June 10, 1925, a hammer workshop worker R. was delivered to the Infirmary, who that morning received a blow in the stomach with an 8-pound piece of steel that bounced off while cutting metal.
Reinecke (according to the ref. In New Khir. Arch., 1925, No. 32) draws attention to a new sign of entrapment of stones in the lower part of the ureter, namely, to a sharp increase and strong sensitivity of the inguinal lymph glands on the same side.
Sgrosso (according to the ref. In Arch. F. Ophth., 1925) used the Bordet method of deflection of complement in trachoma, and in parallel he put it in the studied RW. The antigen was obtained by strong scraping of the conjunctiva with a sharp spoon, the contents of the follicles were immediately placed in 96 ° alcohol.
Kretschmer (according to the ref. In Nov. Khir. Arkh., 1925, no. 32) has developed extensive material covering 933 words. hematuria (cases of hematuria depending on acute gonorrhoid infection and all kinds of injuries are not included here). Most of the bleeding (46.9%) was found to be related to tumors of the urinary tract; stones were the cause of hematuria in 18.5%, tuberculosis in 11.7%, infection in 10% and nephritis in 3%.
In 1919, Schick, in Vienna, observed one woman? regarding which he could establish the following phenomenon: if she took flowers (apemons) with her bare hand during menstruation, then the latter quickly faded; if she took the flowers with her hands, which were wearing rubber gloves, the flowers remained fresh.
Klee's experiments on cats have shown that switching off both vagus nerves causes atony of the stomach and small intestines, while severing the sympathetic nerve results in spasm of these organs.
V.G. Przhevalsky (Tr. I Congress of Khir. Levob. Ukraine, Khark., 1925) draws attention to 3 signs of this disease.
While in previous years these larvae were found in the human eye, as a rarity, and were almost exclusively observed in tropical countries, recently, according to Cecchini (ref. In Zentr. F. Ophth., 1925), they began to be observed often and in Europe. In all cases, fly larvae lay in large numbers in the conjunctival sac. After removing them, there was a complete cure of the conjunctivitis that existed in patients.
A.P. Vladychensky (Russian. Oft. Zh., 1925, No. 8) observed 3 such cases. In one of them, at 55 y.o., the blindness came after those done within 4 months. 10 subcutaneous injections of 4% quinine solution, in the amount of 50.0 each time.
Along with the general eosinophilia that accompanies some forms of gastrointestinal suffering, there is, as you know, local eosinophilia - either alone or together with blood eosinophilia.
K.K.Tsepernik (Tr. I Congress of Khir. Levob. Ukr., 1925) considers resection especially indicated for tbc of the knee joint with subluxations and contractures, but in the absence of fistulas, and this operation should be performed extracapsularly, under the control of X-rays.
It has been established that amino acids enter the bloodstream through the intestinal walls in an unchanged form, and both these substances and parenterally administered protein breakdown products cannot be detected either in serum or in whole blood soon after their introduction. BI Zbarsky (Zhurn. Exp. Biol., 1925, No. 1) explains this fact by the adsorption of protein breakdown products by blood erythrocytes, from which these products can be easily separated by simple boiling, and which transfer these products to the cells of the body.
Master (Journ of Amer. Med. Ass., 1925, No. 10), examining the blood of 15 patients suffering from primary cancer of the esophagus, found in them either a normal blood composition, or even an increase in the number of red blood cells against the norm.
Based on 5 clinical observations and 5 experimental studies, Olbrycht (according to the ref. In "Gig. Labor", 1925, 10) comes to the conclusion that the complete or significant disappearance of epinephrine from the adrenal glands plays an important role in the origin of death from burns. turn, is in connection with the decomposition of proteins in the burnt tissue. Hence, the treatment of burns should be aimed at the speedy elimination of dead tissue and stimulation of the adrenal glands by introducing significant doses of epinephrine.
According to A. Ya. Steinberg (Vopr. Tuberk., 1925, No. 5), tbc tends to be localized not in one organ, but in a whole group of organs (tissues), and these groups are not random, but are determined, apparently, by a common embryological origin.
On the extensive material of the Amsterdam clinic van Tongeren (Zeit. F. Geb. u. Gyn., Bd. LXXXIX. H. I) convinced that the obstetrician in most cases is not able to say whether a woman in labor will have a perineal rupture or not ... Further, he found that septic diseases after a preventive episiotomy occur just as often, even more often than after perineal ruptures, and equally does not guarantee episiotomy against consecutive scar pain.
Zoltan-Bokay (Jahrb. F. Kindhk., Bd. 10, H 1/2) electrometrically determined the concentration of hydrogen ions in the blood of children - healthy (for control), 15 atrophics and 2 with dyspepsia. Atrophics had no deviations from the norm, while children with dyspepsia had acidosis in their blood.
According to the conclusion of LN Poznyanov (Vesti. Sovr. Med., 1925, No. 11), the main danger of lumbar anesthesia is from a drop in blood pressure. To avoid this danger, some authors propose to inject caffeine 5 hours before the operation, others advise adding the latter, in an amount of 0.25-0.5, to the anesthetic solution, and still others, 2-3 hours before anesthesia, repeatedly inject Digalen to the patient. fourth - 0.003-0.004 strychnine. Reschke recommends 3 min. before anesthesia, infect intramuscularly 1 K. Art. adrenaline and, in addition, the same amount should be administered intravenously immediately after anesthesia.
Prof. Halpern (New. Khir. Arch., No. 32), giving 44 pages. peptic ulcers of the small intestine, obtained after gastric resection according to the Billroth II method and published by various authors over the past 3 years, considers such a number of complications to be alarmingly high.
The appearance of short guides on a particular discipline, compiled by outstanding specialists and teachers, is, of course, a big step forward on the path of introducing correct special information into the student body.