At the suggestion of the esteemed chairman of the Society of Physicians at Kazan University, it has fallen to me the honor to share my recollections of the late Prof. S. S. Zimnitsky. As one who worked with the late S. S. for about 10 years and was associated with him personally, I recall many strokes of his life both from his personal accounts and partly from his autobiography.

Russian medicine undoubtedly lost in Professor S.S. Zimnitsky one of the major therapists, a learned clinician, very gifted, with an inquisitive, eternally searching mind of a philosopher researcher. It is difficult now, when this loss is still so fresh, to draw a full and true picture of S.S.'s scientific quests and give an objective assessment of what he contributed to our science - difficult because new ideas in medicine often lose much to contemporaries just when they are especially bright, especially paradoxical, and are recognized as scientific truth only much later, when they have passed all tests of strict and often biased criticism.

The question of the functional relationship between the individual glands of internal secretion has long attracted the attention of a number of researchers, and despite the huge number of works in this direction, the department of the relationship of the insocrine organs is one of the most obscure chapters of endocrinology.

In our previous work "To the teaching of the functional diagnostics of the reticulo-endothelial apparatus" we, using Adler's and Reimann's methodology, established that determination of colloidal solutions excretion from human blood, producing intravital staining, gives an opportunity to judge about the function of the reticulo-endothelial apparatus. We made the following statements: 1) In healthy humans one hour after injecting into a vein 10 cc. 1% dye solution, 30% of it remains in the blood. 2) In infectious patients there is a delay of dye withdrawal from the blood depending upon the case gravity: a) at easy infections in an hour after dye injection into a vein 50% colloid remains in the blood plasma of patients, b) at severe infections in an hour after intravenous injection 70-80-100% of the dye remains. Retention of dye in the blood plasma is also observed in infected rabbits, as well as in white rats infected with Duttoni spirochaete. Subsequently, we continued our studies and became even more convinced of the correctness of our statements.

Blood sugar quantification is very important in a number of disease states and has recently become particularly important in assessing the results of insulin therapy and its danger in terms of the occurrence of hypoglycemia. It is also important for determining the severity of a metabolic disorder and for prescribing therapy in cases of diabetes, when glycosuria is absent or negligible, and also in insulin therapy of nondiabetic conditions, where at the beginning of treatment there is no hyperglycemia, and due to this there is a danger of causing the latter. Finally, it is established that the state of the autonomic nervous system and the endocrine apparatus in general is reflected in the blood sugar content.

In practice, clinicians often have to face a number of difficulties in the recognition of congenital heart abnormalities, because very often the data available for the diagnosis, such as the boundaries of the heart, its murmurs, etc., are so similar for various defects of this organ that it becomes extremely difficult to differentiate on the basis of these defects. Particularly difficult is the diagnosis of congenital heart disease, for which recognition during life is often only a more or less probable guess. A detailed diagnosis of congenital heart disease," says Вalfour, "is a wide field for romance".

Mineral waters in the treatment of diseases of the digestive tract everywhere enjoy a well-deserved reputation. Unfortunately, they are not widely available due to their high cost and often simply because they are not available in many remote areas. In addition, during the long transportation to the places far from Caucasus, the main supplier of our waters, the possibility of changing the very composition of the mineral water is not excluded. Due to these reasons especially Siberia is forced to use artificial instead of natural mineral waters, and the comparative value of artificial and natural waters is especially important for it. Clarification of this question is the task of the present work.

On 5/V1 1926, patient A. L. was admitted to the Surgical Department of the Vetluga Hospital. L., forty years old, with a missing nasal tip. It turned out that the tip had been bitten off by her husband six months ago. Both the coccyx and a portion of the wings of the nose were missing. Other than this she has no other illnesses. An operation was performed on 7/VI under novocaine. For nasal tip formation a part of the patient's auricle greater than one centimeter in width and about one centimeter in length, of full thickness, was taken and freely transferred to the previously prepared, refreshed surface of the nose by removing the scar tissue. The graft took root well. The nose, to the displeasure of the patient's husband, turned out quite beautiful. Healing passed without any complications. The stitches were taken off on 12/VI and the patient was discharged on 3/VII. The temperature was normal all the time. The patient was kept in the hospital for some time to see if there would be any changes in the newly formed nasal tip, but there were none.

The issue of postpartum infection and measures to combat it, despite its antiquity, has not lost its relevance at the present time. There are two main reasons for this: firstly, the fact that, in spite of all modern aseptic precautions in childbirth and the introduction of sub graviditate prevention, the rate of maternal morbidity has not been reduced to the desired minimum; secondly, the fact that we still do not have a fully reliable treatment for postpartum sepsis.

In the present note I would like to share my experience of mass psychotherapy for alcoholics conducted in the Kursk Psychoneurological Dispensary. The basis for this note was, firstly, some innovations about which we did not meet in modern medical literature and, secondly, that this method is possible in any not only urban, but also in rural outpatient clinics.

Elephantiasis arabum is a group of diseases with a characteristic clinical syndrome, pathogenesis, with local pachydermia and hypertrophy of all layers of skin and subcutaneous tissue. A common distinction is made between: 1) sporadic elephantiasis, 2) endemic, 3) congenital, and 4) secondary. If the clinical picture, pathological and anatomical changes and, probably, pathogenesis of this disease have been studied rather well, the same cannot be said about etiology.

Let us now turn to the second group of cases, cases in which doctors are accused of crimes in office. It is quite natural to expect such cases, and even in fairly large numbers, since the vast majority of doctors in the Soviet state are in state and public service, and omissions and abuses, as well as misunderstandings, are always possible in the working environment and can be the basis for a legal case. It must be said to the credit of our medical staff that there are very few such cases, and that the majority of such cases are misunderstandings overblown to inadequate proportions.

In the present essay I will try to give a brief account of the extremely interesting question of syphilitic fever, which has not yet received its final resolution. The closest reason that has prompted me to present syphilitic infection as a febrile process is the observation by authorities in the field (Buschke, Fischer, Freund, etc.) that syphilis has recently been reported to occur frequently with febrile increases in t°.

The author reports that out of 319 tuberculous mothers of his material, 36 died of severe forms of tbc in the first 10 days after delivery, noting also the tendency of patients with severe forms of tbc to have abortions and premature births. Having examined six children born prematurely of tbc mothers, in 3 of them he found tbc bacilli directly in the glands; from the others by inoculation of juice from the organs a bacillus was isolated which was badly stained by Ziehl's and caused no specific changes.

Complement fixation both in specific reactions (toxin and antitoxin) and in nonspecific reactions (colloidal metal solutions), as well as in the Wassermann reaction, is due to the whole complement rather than its separate fraction. Specific in all these reactions is not the fixation of complement, but those processes that lead to the formation of physicochemical complexes (immunobiologically bound or not) capable of fixing (adsorbing) complement.

The tbc bacillus is known to have a filtered invisible form, which, according to Rabinowitsch-Kempner's experiments, passes through the placenta in pregnant animals (guinea pigs), becoming an acid-fast bacillus in the young generation. The virulence of this bacillus is apparently very low; it rarely causes progressive tbc in young animals.

The author describes an infiltrate in the subclavian area that he has observed in persons in contact with open forms of tbc. With appropriate treatment (pneumothorax), the course of such an infiltrate is favorable.

Two properties of complement are distinguished: 1) hemolytic ability and 2) the ability to bind (deviability) not standing in relation to each other (complement with a good hemolytic titer can bind poorly and vice versa). Observations on a number of syphilitic sera have shown them that with the same ingredients and methodology, the same lab technician will get different results in the same syphilitic sera, depending on the different deviability of the individual complement (with the same hemolytic titer).

Serum treatment of this disease has rightfully superseded all other methods of treatment. All local measures are almost superfluous with it. The liquid serum is superior to the dry one.

In this area we should note H. Friedrich's indication that by blowing air into the knee joint it is possible to determine, by X-ray, the sclerosed fatty tissue, which in many cases is the cause of impingements, or a concomitant point in a meniscus injury.

About half of all patients with tuberculous inflammation of the peritoneum recover - regardless of whether they were treated operatively or conservatively. The main role here is played by arbitrary cures.

Experimental studies on the effect of tbc toxin on the female reproductive sphere were first performed by the author who injected into rabbits a certain dose of suspensions of killed tbc bacilli, the toxicity of which has been strictly established. In doing so, the author obtained histological changes in the ovaries in utero much more easily than when other microbes were injected. In particular, in the ovaries of adult rabbits, degeneration of medium-sized follicles proved to be specific for tbc toxin.

In view of difficulties with which X-ray examination of the duodenum by conventional methods is connected, Pribram recommends to resort to introduction of air during this examination. First, a duodenal probe is inserted to the middle of the descending part of the 12 duodenum, and through it 10-15 c. c. barite is injected into the intestine, after which the duodenal area is massaged. Then, in the standing position of the patient, air is injected into the intestine through the probe by means of an ordinary rubber balloon.

In 3 cases of the disease after illumination with small x-rays, the authors obtained a rapid reversal of tbc processes in the eye, namely, productive at first, and somewhat slower in excretory ones.

The author argued that pulmonary syphilis, the possibility of which in adults is totally denied by some authors and considered rare by others, especially tuberculosis specialists, is in fact not so rare at all. The author describes 16 cases of the disease, of which he personally observed 12.

According to observations of the authors, given at short intervals large intakes of carbonated lime and burnt magnesia are very favorable for uncomplicated, non-bleeding stomach ulcers (and duodenal ulcers) and acidic gastritis, if prescribed simultaneously non-irritating, dairy and vegetative diet.

According to Bruno, there are cases in which there are simultaneous attacks of dyspnea and attacks of pectoral sinus. In some of them, injection of the cerebral appendage extract, which is usually excellent for pure cardiac asthma, quickly eliminates all phenomena.

In all cases, where there is irritation of renal pelvis, as well as in the presence of purulent processes in the kidneys and ureters, the author recommends injecting warm air into the renal pelvis instead of some liquid. Having used this method in 305 cases in 192 patients, the author always obtained an excellent X-ray picture and never observed any complications.

The author does not share the pessimistic view that the process in the larynx is incurable. As with pulmonary tbc, climatic and hygienic factors play a major role here. One of the most important conditions for cure, according to the author, is-silence, Schweigekur. The cough must be suppressed.

The author draws attention to the increase in deaths from thrombosis and pulmonary embolism in recent years according to the Hamburg Pathological Institute). This increase is noticed also, even especially, in patients with internal diseases.

The author describes the following case: a patient 2 years ago had allegedly suffered from typhoid fever and since then has been experiencing pains in the right thigh, which doctors sometimes take for rheumatic or neuralgic; there are no outward signs of disease in the thigh, only a strong pain on pressing in the middle part of the thigh from the outside.

Having made several experiments on animals (dogs), the author found that, contrary to the opinion of some authors, the absorption capacity of the omentum is very small, and that the resection of part or even the whole omentum has no effect on the speed and intensity of the blood poured into the abdominal cavity.

The authors are ardent supporters of the old conservative method of treatment of this disease. In their opinion, in this latter case it is necessary first of all to establish a good drainage of the focus as early as possible with a minimum of surgical trauma, then to wait until the virulence of the infection decreases and the dead bone separates spontaneously from the living one, and finally, at this favorable moment to remove all fragments of dead bone, affecting as little granulation as possible.

The author reports 1000 cases of goiter operations without a single fatal outcome. He attributes this success to the strict development of indications for surgery and the technique of surgery.

The authors divide splenomegaly into 2 groups: 1) proliferative, where surgery is contraindicated,-this includes splenomegaly in leukemia, pseudoleukemia, spleen disease, and spleen sarcoma. Nodgkin'a and sarcoma of the spleen; 2) inflammatory chronic,-in tbc, syphilis, kala-azar, naludism, etc. In the latter group good results from splenectomy have been noted: Mauo, for example, had 7 successful cases out of 8 cases of tbc of the spleen and 5 successful cases out of 6 luetic splenomegaly.

The author places postoperative bloody vomiting in association 1) with postoperative ecidosis, 2) with thrombopenia, and 3) with intraperitoneal postoperative hematoma.

Long-term results of operative strengthening of the humeral head in recurrent dislocation were traced by M.S. Henderson using a large material. Of 19 people operated on by capsulorrhaphy, 8 had a lasting recovery (42.1%), 6 had an improvement (31.6%) and 5 had no success with the operation (26.3%).

The authors predispose to this disease: Jewish race, belonging to the wealthy classes, male gender, and age over 40 years. Causes: congenital narrowness of the vascular system, neuropathic predisposition, seminal tendency, diabetes, gout, nicotine, syphilis, alcohol, soaking feet, flat feet, etc. The disease is characterized by motor, sensory, and vasomotor disorders.

The remedy, which is a sterile solution of basic quinine and camphor in essential oils, is successfully used by Jung for treatment of bronchiectasis, infectious asthma, bronchitis and pneumonia. To prevent postoperative pneumonia, it is administered 2 cc. cm. into the muscle daily for 3 days after each inhalation anesthesia.

The author recommends drip infusions of 100-800 cbm. of chamomile tea with the addition of 20 drops of opium tincture to eliminate thirst after surgery: only children, unfortunately, do not retain them.

The authors have proved that injection of neosalvarsan directly into the eye by iontophoresis (in keratitis parenchim.) gives much better results than injection into the vein. Already at 20-minute iontophoresis with 1% solution of neosalvarsan it is possible to detect arsenic in the anterior chamber of the eye.

The author used local anesthesia in 33 cases of closed fractures of tubular bones and was successful in 31 of them. The anesthesia technique consists of injecting novocaine with adrenaline under the periosteum, in the fracture focus, up to the contact with the bone marrow, and the muscles adjacent to the fracture.

Based on 3 own cases and literature data, the author recommends rejuvenation surgery in the form of bilateral ligation of the descending seminal tubules with resection of part of the appendages: for some cases of primary glaucoma, mostly inflammatory: this operation in such cases causes a sharp increase in general vital tonus, visual acuity increase, increase in its field and decrease in intraocular pressure.

The author cites a case of pseudarthrosis in a 5-year-old girl in the lower third of the tibia. The patient was operated as follows: subcutaneous tenotomy of the Achilles tendon and redressing of the tibiae; after exposing the pseudarthrosis site, reviving the articular ends and separating the periosteum in a circle, then sawing the bone-periosteal plate along the entire length of the tibiae and dividing it into 3 equal pieces, which are attached to the periosteum on the tibiae from three surfaces outward; these pieces are attached to the tibiae periosteum with catgut sutures. The cast is in place for 3 months.

The author reports the successful use of this technique for fracture repairs. The "cepa" technique used in the posterior dislocation of the elbow joint (according to Jaboulay's idea) is as follows: The shoulder is withdrawn by 90°, its lower part, above the elbow bend, is embraced by both hands of the operator so that the palms rest on the front side of the shoulder, the fingers are crossed, and the thumbs rest on the olecranon and press the latter down toward the forearm; the forearm hangs free down; then a quick and strong movement shakes the forearm to resemble a chain in threshing.

The author reports three auxiliary techniques in the extraction of senile cataracts, which he finds very valuable. In his clinic, retrobulbar anesthesia is now routinely used, even in normal cataract extraction.

Автор дает сводку современных методов исследования и терапии бесплодия. Многие из этих методов связаны с именем автора. Продувание труб, в особенности же сальпингография - позволяют точно установить степень и место непроходимости труб. Для случаев, где непроходимым является участок в р. isthmica трубы, автор рекомендует т. н. ретроградное продувание, которое производится через абдоминальное отверстие трубы при чревосечении и позволяет более точно установить, какой отрезок трубы мог-бы оказаться функционально-пригодным.

According to Sattler, this synthetic drug, similar to ephedrine and adrenaline, when injected in a 5% aqueous solution and the conjunctival sac, gives moderate pupil dilation for 2-3 hours without accommodation paralysis. Mydriasis can be increased by adding 0.3% homatropin to the 5% efetonin solution.

The author performed a series of experiments on rabbits with injections (subcutaneous or intravenous) of sperm emulsion (rabbit or bovine) to females. These experiments convinced the author that parenteral injection of spermatozoa leads to temporary sterilization of females without disturbing other functions of their sexual apparatus and ovulation in particular.

The author emphasizes that the treatment should start as early as possible and be carried out with large doses. The technique consists in administering to the patient 500 c.c. of physiological saline solution with adrenaline for 1¹/₂ hours, and to this solution the anti-streptococcal serum is gradually added.