In this brief report, I would like to share some results obtained in the study of the cerebral arterial system of persons related to each other by blood kinship. Collecting material on the question of racial peculiarities of the brain, last year, with the kind assistance of forensic physician O.I. Korchazhinskaya, I received the brain of a woman who died in the ninth month of pregnancy, as well as the brain of her fetus. Such material is a well-known rarity for our Institute, so it is natural that I wanted to study the received brains as comprehensively as possible; in particular, the arterial system was removed and fixed. At the same time, in order to preserve the brain for further study, I used the method of simultaneous study and preservation of both the brain and its arterial system.

More and more attention is paid to the effect of cations on living protoplasm. It was proved by Loeb that quantitative ratio of one of divalent cations has a great influence on excitability of living tissue (Loeb's coefficient), - increase of the former leads to excitation, and of the latter - to suppression of cell function. The former include Na, K, NH4, and the latter include Ca and Mg. What is applicable to a muscle, a nerve, may also be applicable when testing a whole organ. Particularly on the stomach, this effect of cations was tested by Pravdich-Neminsky with respect to changes in its motor function.

Very often the first signs of tuberculosis are tachycardia, slight excitability of the heart and other cardiac phenomena with very little change in the lungs or bronchial glands. On the other hand, on the basis of some cardiac diseases, undoubtedly, pulmonary sufferings can also develop. Thus the relationship between vascular and cardiac diseases on the one hand and pulmonary diseases on the other is undoubted.

Typhoid fever, according to the duration of its course and the possibility of complications and a number of surprises, belongs to the category of those diseases where the doctor at the bedside is in the same position as those around him - from the moment of setting the diagnosis he cannot, even approximately, say anything about the duration of the disease itself or about the nature of its course, and all his struggle with typhoid is limited to symptomatic therapy. For this reason the efforts of the medical world have long been directed toward finding a specific treatment for the disease. Sero- and vaccine therapy of typhoid fever, however, has not yet given tangible practical results, because, although some authors point to shortening the duration of the disease and lowering the mortality rate, I think that other factors may play a role here, such as the nature of the typhoid epidemic, the degree of hospitalization of patients, etc. Leaving aside the issue of sero- and vaccine therapy, as it is not within our scope, I would like to touch only the drug treatment of typhoid fever. Here, too, the situation is very sad.

The present report aims to draw attention to extremely interesting morphological changes in blood elements, which we observed in purpura variolosa, and to emphasize their diagnostic value in recognition of this disease. It is more practically important, because the diagnosis of purpurae variolosae is often difficult, the disease in sporadic cases is rarely recognized and sometimes, due to similarity with the clinical picture of purpurae fulminantis, it is mistaken for the latter.

In recent years, Russian medical literature has been enriched by an excellent monograph by S.S. Yudin devoted to spinal anesthesia. This book, with its wide coverage of the issue and the author's vast personal experience, fills a gap on this important issue. Nevertheless, in view of the great interest that the questions of anesthesia cannot but arouse, it seems to me not unreasonable, though in brief, to outline our experience in this respect as well.

Work in the clinic of emergency surgical care convinced me how few free patients with acute attack of appendicitis in the first day of the disease are delivered to surgeons in Kazan and how, on the contrary, relatively many of them are delivered with severe complications of appendicitis - appendectal pustules and peritonitis, both limited and diffuse. This circumstance prompts me to pay attention to the question of timely intervention in acute appendicitis - a question which does not exist in the West, does not exist in America, which is solved in our centers, but which in conditions of the Kazan reality acquires a special importance.

The vast majority of cases of intestinal obstruction are clinically acute, belonging to the group of diseases requiring emergency care. In this kind of cases we usually have enough data at our disposal to ensure correct recognition. It is true that in some cases the type and location of the intestinal obstruction may remain unrecognized, but in practical terms both for the doctor and for the patient this circumstance is not of great importance. Let it be a blockage of the intestine, its twisting or intussusception - in all cases we face an acute form of the process, which requires urgent intervention, which must lead to one goal - elimination of the obstruction, the main moment, which determines all the severity of the disease.

Pregnancy in the interstitial part of the tube, i.e. in the part of the tube that lies in the uterine wall, is relatively rare. Thus, according to Rosenthal's compilation statistics, among 1,324 cases of ectopic pregnancy, 3% were interstitial. Lawson-Tait notes only one case of interstitial pregnancy per 100 cases of ectopic pregnancy. In Povival Institute (Prof. Ott) from 1904 to 1907 on 71 cases of ectopic pregnancy also met only one case of interstitial pregnancy. Gubarev saw the latter only once in his practice. Werth did not see it even once. During the 35 years of the existence of the Obstetrical Clinic of the Leningrad State Clinical Institute, the first case of interstitial pregnancy was described only in 1924. The four cases of interstitial pregnancy described below are also the first in the last 28 years of the Kazan Obstetrical Gynecological Clinic.

In children, Graves' disease is rare: according to the American literature, for 1,512 cases of the disease in the Mauo Clinic, there were only 5 in children under 10 years of age, which is equal to 0.3%. Klein cites at 3,477 cases of 184 in children under 15 years of age, equal to 5%. The French literature, according to Barret, describes 100 cases of basid disease in children under 15 years of age, including 64 cases between 10 and 15 years of age, 28 between 5 and 10 years of age, and the rest before 5 years of age. In the German literature, according to Sattler's data, for 2,934 cases collected by him from the literature and his own through 1910, 184 cases fell in childhood, i.e., 6.3%; of which there were 11 cases between 0 and 5 years of age, 54 from 5 to 10, and 129 from 10 to 15 years of age. In Russian literature we have found only a few cases of the disease in children.

Based on the nervous theory of eczema and proceeding from the fact that our methods of their treatment are reduced to external itching remedies, Prof. Lebedev was the first to try treatment of some forms of skin diseases by intravenous infusions of bromine salts and obtained good results in many cases. Of the Russian authors who have dealt with this question, we can mention Bobovich, Matousses, Tonian and Volpian, and of the foreign ones, Mankowsk'os (Vilna), Wolff (Altona) and Hübschmann (Prague).

Last autumn of 1927 I accepted a proposal of the Mari Autonomous Province Department of Health to investigate the iodine content in the drinking water of some villages affected by goiter, having made a trip to take samples and to observe the local morbidity. As far as I know from available Russian literature of the last years, similar researches were not made in our country, and therefore it seems to me, the results received by me, will be interesting for the publication. I visited some villages in Zvenigskiy canton of the region and I did 16 tests on iodine content in water samples taken in these villages. I will briefly summarize the data of my inspection, as well as the results of the analyses.

I will not dwell on all the huge literature on this issue, but I will only note that all these works can be divided into two groups: some of them were aimed at obtaining crystal hemoglobin to study its properties, while others were mainly aimed at establishing the differences of blood of different animals by the shape of hemoglobin crystals. It is quite natural that this second group of studies appeared already after the most important morphological properties of crystals had been studied.

The extremely complicated question of congenital syphilis, which for decades had been the subject of comprehensive and careful study, seemed to find a solution at the beginning of this century in Matzenauer's major work, which exhaustively covered this tremendous problem and established the basic laws of parent to fetus transmission. It seemed that clarity and certainty were introduced into the question, leaving no room for doubts and disputes and reconciling the representatives of various theories. However, during the last two decades, in connection with the accumulation of colossal material on syphilis serodiagnostics and in connection with the attempts of some authors to make some changes in Matzenauer's teaching on the basis of purely clinical observations, congenital syphilis again becomes an acute topic of modern syphilidology.

Having carried out a number of studies in this direction, Prof. A. A. Maksimov was convinced that BCG bacilli differ from bovine tbc bacilli in their much weaker virulence. The main role in the tissue protective reaction against tbc infection belongs to polyblasts and their transformation products-epithelioid and giant cells, which develop partly from histiocytes, partly from non-grain leukocytes, lymphocytes and monocytes.

On the sanatorium material the authors studied the comparative value of Daranui, Brusk'a, Соstа reactions and erythrocyte sedimentation rate. Their conclusions are that Daranui p. is the most valuable and necessary, because it subtly conveys changes in the course of tbc process, being the most correct indicator of the activity of the process.

Stating this extremely interesting and important question and based on the works of Assman and Redeker, Prozorov and Kantorovich on the basis of their 19 cases give the clinical and roentgenologic picture of the initial tbc infiltration in adults. This large focal infiltration, located close to the pleural surface, is most often found at the level of ribs II and III on the right, in the upper lobe of the lung, and is characteristic not only of adolescence. With progression of the process, its pneumonic forms with decay of lung tissue are also observed, but in most cases the infiltrate is resolved or becomes melted.

The author cites data on 78 cases of endocarditis found in the Graz Pathological-Anatomical Institute. These cases fall into 4 groups: 1) endocarditis simplex-36 cases, 2) end. reumatica-6 cases, 3) end. maligna polyposa-35 and 4) end. ulcerosa-1.

The authors found that adenitis hyperplastica, caseosa and purulenta are favored by such treatment, and caseous adenitis lends itself little to it.

The author identifies it in 2.1% of all cases and in 2.8% of open tuberculosis cases. The presence of leukocytes in sterile urine is particularly important for early recognition.

The author uses this transplantation in some cases of tbc lesions of the named joints, namely, mainly in the initial stages of the process when the joint is still mobile and there are no infiltrates or fistulas. During the operation, the affected synovial membrane is removed at the same time, and the adjacent bone epiphyses are scraped out with a sharp spoon.

The authors report a case of cure of the patient of 44 years old, who after long-term (2 years) treatment with different remedies was almost dying; her hemoglobin was 29%, red cells - 300,000. After 2 weeks of treatment (250 gm of liver per day, in 3 intakes) her hemoglobin content increased to 70%, and number of red cells - to 2.5 million, with corresponding improvement of the general state.

The causes of mucous colitis are very different: mechanical, chemical, nervous. Septic foci in the teeth, in the tonsils, in the pelvis also often play an important etiological role here. If none of these causes is found, then colitis is based either on a metabolic disorder or on disorders of the nervous system.

This combination is relatively uncommon in practice, and in these cases, along with the characteristic pain, there are also attacks of shortness of breath. In such cases, injections of cerebral appendage traction help, and very quickly.

In one case of a traumatic pancreatic fistula the author was convinced that the body could tolerate the loss of pancreatic juice for 1/2 year without any objective and sub-objective disorders. The hydrochloric acid taken per os increased the pancreatic juice excretion in the patient, and the alkalis decreased it, so that the gland reacted as if it were healthy.

Treatment of this disease with emetine, carried out by Manson-Bahr (in 87 patients), gave quite satisfactory results in the early stages of the disease, but in chronic cases it was unsuccessful, despite high doses of emetine (up to 80 gr and more).

Based on extensive statistical material, the author emphasizes the need for possible early use of insulin in diabetic coma: if treatment is started in the first 6 hours after the onset of loss of consciousness, almost all treated patients recover; in contrast, after 12 hours hope for the preservation of life is almost zero.

The author operated on a 52-year-old man for penile cancer; the operation consisted of amputation of the penis and excision of the inguinal glands, and the wounds in the groin could not be sewn shut. Two months later, there was an inflammation of the rotting in the area of the groin wounds, which had not yet completely healed. The rot then recurred between 3-6 weeks, after which there was complete healing of the wounds with no recurrence.

The author has seen good results with this disease from intravenous injections of 50% cacodyne solution in increasing and then decreasing amounts (1-6 cc), at intervals of 3 days. Cases complicated by pulmonary tuberculosis are excluded from here.

The author considers such injections an excellent remedy against inflammatory furunculosis. Usually the healing time is greatly reduced and the scarring is negligible.

Since 1908 the author has performed 6000 lumbar anesthesias. On the basis of his experience he establishes the following contraindications to the latter: 1) age under 15 and over 70 years old; 2) short-term operations, or those which can be done under local anesthesia; 3) former or present nervous system disorders; 4) low blood pressure (from this point of view spinal anesthesia is contraindicated in bleeding, general peritonitis, shock and infections). The author also does not use it in breast surgeries.

Having lost two patients after gastric resection from septic peritonitis, the author believes that the best protection against bacteria brought with food is acidic gastric juice. Therefore, he has recently taken it as a rule to give hydrochloric acid to patients before and after gastric resection and, in addition, to wash their stomachs with physiological solution of table salt.

The author recommends for this purpose 1) not to transplant both ureters simultaneously, but first one, then after a few months, the other, 2) after the operation to introduce a permanent tube in the rectum to drain the urine, 3) to inject patients before the operation of bacteriophage.

The author offers an original access to the spleen: the skin incision starts at the VIII intercostal space on the left, passes to the abdominal wall, following the direction of this intercostal space, and ends at the midline, slightly above the navel, forming a slightly bent down line. First, only the abdominal cavity is opened, and if it is necessary to extend the incision, the diaphragm incision from the chest wall in the same intercostal space is joined to the latter after preliminary stitching of the diaphragm with the intercostal muscles.

The author drops a 3% hydrogen peroxide solution on his soapy hands, producing an abundant foam with the development of oxygen. This foam, he claims, cleanses deep skin pores and frees them of bacteria.

The author reports the results of his investigations made with the device he invented to measure the axial mobility of the eyeball. This latter has differential-diagnostic value for the characterization of a suspected retrobulbar tumor.

The author suggests percussion of both anterior-upper axes of the iliac bones in a patient in a supine position for early recognition of coxitis. In the initial stages of the disease, percussion on the diseased side, due to depletion of bones with calcium salts, produces a less muffled tone than on the healthy side.

The mother and her fetus may have different blood groups, which some have tried to explain such pathological phenomena as eclampsia. Signs characteristic of certain blood groups are characteristic not only of blood cells, but also of cells of other tissues and organs (liver, kidneys, spleen, etc.). Group-specific constituents can be obtained from these organs in an alcoholic extract.

The author reports 7 cases of such treatment in the eye clinic of Prof. Slavik in Brno. The vaccine was administered in an amount of 25-550 million bacterial bodies 10-12 times. The rapid progression of the disease usually stopped after that, but its reversal was observed only in 1 patient.

Spirochaetes are found in the said secretion in 2/3 of sick children. They appear here with the beginning of the disease symptoms. Usually these children have a specific infiltrative conjunctivitis.

On the basis of experiments on rabbits and observations of patients, especially those suffering from iritis, the author concludes that the most valid form of protein therapy is the use of normal horse serum. It is more valid than milk, etc. substances.

The author suggests using diuretics for uterine bleeding on the following grounds: it is known from numerous experiments on patients with diabetes insipidus that pituitaryrin reduces diuresis; the posterior pituitary gland, which is the site of pituitaryrin production, plays an important role in regulating the water content in the body - its task is to protect the body from too much water loss; if a large amount of water is extracted from the body, the pituitary gland begins to produce pituitrin intensively to inhibit further water withdrawal.

The author describes a case of a 46-year-old patient who was admitted in the fourth month of pregnancy (fifth month) with severe jaundice, a huge spleen, and signs of liver atrophy. The miscarriage proceeded safely. Fourteen months later the patient was found to have some reduction of the spleen.

Such a diet is indicated in tetany, food anemia, effusion diathesis, idiosyncrasy to cow's milk, eating disorders (especially in older atrophies), in neuropathic infants without appetite and in rickets with an enlarged stomach.

The author was convinced that 0.3% lactic acid solution kills Goldenseal, while 0.3% solution, on the contrary, provides a favorable feeding environment for it, acclimatizing in which Goldenseal can then tolerate 0.5% solution of Asid lactici without any harm to itself.

On the basis of observations on small children suffering from frequent convulsions, which were made during several years, the authors came to the following conclusions: 1) there are 40-50 syphilitics per 100 children suffering from convulsions, 2) there are 5-6 syphilitics per 100 children suffering from convulsions, and 3) there are 20-25 syphilitics per 100 children.

Bearing in mind that in some districts of Czecho-Slovakia the above mentioned drug is used by pregnant women to induce miscarriage, I made several experiments on guinea pigs, which were given 0.01-1.0 salicyl Na per day for 1-2 weeks, and observations on 65 women, who were 4-24 weeks pregnant, in which pregnancy was shown to terminate - 45 cases due to pulmonary consumption, and 8 cases due to heart defects; these women received 6 grams. salicylic acid Na per day, 3 days in a row.

The author advises that in cases of pneumococcal empyema in children, pus should be discharged by puncture, followed by washing the cavity with ½% optochini basici solution, leaving 0.025 of the product per kilogram of child weight (in a 5% solution) in the cavity after each puncture.

In view of the fact that the diet hitherto used in young children for diarrheal diseases is not complete because of the lack of fat and leads to exhaustion when used for a long time, B. Balaban on the basis of the work of Czerny, Moro and Kleinschmidt indicating that fat administered in the right proportions and in the appropriate form is also tolerated by the labile intestine, performed a series of experiments using Czerny and Moro mixtures for diarrhea. A total of 40 cases were carried out by him, the central group of observations being diarrhea in dystrophics.

The authors observed a very favorable effect of this remedy on vomiting in infants and older children. Where the therapeutic effect of hypophysine alone was insufficient, combinations of hypophysine with atropine or adrenaline helped - by reducing the stay of food in the stomach, they, at the same time, eliminated vomiting.