Currently, it is becoming more and more clear what the primary importance of properly delivered polyclinic teaching is in the general plan of studying medical disciplines and conducting a seminar-practical method of teaching at medical faculties. In the polyclinic, students, under the supervision of a professor and teachers, but at the same time quite independently, conduct analysis of patients and practical work, where, along with complex and severe patients, they see the most ordinary, easy cases and where they have the opportunity to observe and study many things that they will not find in an inpatient clinic. During polyclinic classes, all students of the last year are divided into small groups for conducting work, the main task of which is to practically assimilate modern scientific methods by students and develop the ability to independently understand diseases, group them and scientifically analyze the data obtained. A large number of patients visiting the polyclinic presents a very diverse material for seminars and practical classes, where, along with serious and complex cases, a large number of the most everyday, everyday diseases take place, with which the future doctor needs to be familiar and which are so often absent in inpatient clinics.
None of the organs located in the human abdominal cavity gives such a frequent and diverse deviation from the norm, which the kidneys give us. We can observe various variants in the sense of their incorrect position, shape, size, and even number in subjects who are completely healthy and do not suspect this. Obviously, these kidneys cope with the work assigned to them by the body—the regulation of water and the release of metabolic products in the same way as normal ones.
As it is known, T. naz. the antivirus has according to the data from Time to time several characteristic features: 1) it causes a specific delay in the growth of those microbes that served as the starting material for the preparation of this filtrate, 2) it specifically immunizes without the formation of antibodies in the body, 3) it is non-toxic and 4) it is very thermally stable, since it does not lose its properties even when boiling for 1 hour or at 120° for 20 minutes.
Five years have passed since the publication of " a new blood chemical reaction for gender recognition of Dr. Manoilov. During this time, both the author of this reaction and many other researchers managed to establish the fact that " under the same conditions, namely: with the same reagents and in the same quantities, the entire visible world, the whole nature, living and dead, can be divided into two parts, that all three kingdoms of nature open with one bite: the male and female half in the animal world, the male and female principle in the plant world, cubes and diamonds in the mineral world..."
Of acute lung diseases, croup inflammation is of the greatest interest, which is why I will allow myself to share the results of my 5-year observation of this disease in the Ufa Therapeutic Hospital.
The first manifestation of the conduction difficulty in the Aschoff-Tawar node of the His beam is the elongation of the P—R interval on the electrocardiogram. The P—R interval is usually equal to 0.1", it rarely extends to 0.15", even less often it reaches 0.2", in pathological cases it can reach 0.25" and higher.
In contrast to cancerous neoplasms of the stomach, which are quite common and have a well-developed literature, gastric sarcomas (primary) are very rare. The question of primary gastric sarcomas still does not come out of the period of accumulation of material, there are relatively few descriptions of individual cases, summing up works (Krichevsky, Flebbe, Va imane, Konietzny, Orator, etc.). Due to the same rarity and the lack of precise reference points for the diagnosis, gastric sarcomas are, for the most part, an unexpected find at an operation or, more often, at an autopsy. The classic cases of Westphalen, Fleiner and Laibe, who gave a preliminary diagnosis, the first on the basis of tumor pieces in gastric lavage water, the second on the basis of sarcomatous nodes in the skin, are isolated; the difficulty of lifetime recognition of gastric sarcomas is explained by the variety of anatomical forms that have different course and not rarely barely noticeably upset the patient's health.
Almost in any manual of private surgery, you can find indications that epigastric hernia is extremely often accompanied by dyspeptic phenomena. Patients in their complaints note pain in the epigastrium, which increases especially after eating, a feeling of heaviness in the stomach, nausea, heartburn, sometimes vomiting, weight loss, etc. Often the patient's complaints make the attending physician think about a stomach ulcer, about "stomach catarrh", gastric neuralgia, etc. D., and patients are treated for a very long time and to no avail until they get to a surgeon and are relieved of their suffering by a radical operation. Hernia epigastrica can simulate various diseases and give an extremely confusing clinical picture, as evidenced, for example, by the case of Zykov, which briefly consists of the following:
Primary tumors of the adrenal glands, as an object of surgical intervention for a practical surgeon, are very rare and usually unexpected. This type of neoplasm, already rare in itself, is more often included in the field of view of the pathologist at autopsies of cases where, during life, a completely different nature of the disease process was sometimes assumed. The clinical picture of the development of a tumor in the adrenal gland b. h. does not distinguish any particularly typical and reliable signs, guided by which it would be possible to determine the true nature of suffering with great probability. Therefore, as far as can be seen from the literature on this issue, a lifetime (before surgery) diagnosis of an adrenal tumor was established only in isolated cases.
Rhinolaryngopathologists have to deal with cholesteatoma more than representatives of other dissin, but they are used to meeting it most often in the cavities of the middle ear. Looking through the special literature on this issue, we find only isolated cases of describing the defeat of cholesteatoma of the adnexal cavities of the nose. Without going into a detailed histological and pathological analysis of the question of a pearl tumor, we will briefly only touch on the views and theories of the occurrence of this tumor. Virchow considers the cholesteatoma to be a neoplasm and as proof puts forward the position that normally there are no cellular elements in both the cavities of the middle ear and the appendages of the nose, from which the specified tumor is formed, and they are, as it were, lost. It should be noted that here we are talking mainly about the epidermoid elements because they are the basis of the cholesteatoma. The above-mentioned cells, under favorable conditions for them, begin to grow and, undergoing a number of biochemical processes, form a tumor. As a product of the reaction from the surrounding tissue, cholesterol and fatty acids are released, which contribute to the bonding of growing and peeling epidermoid cells. It is worth noting that the specific cholesteatomic smell that we usually observe in all cholesteatomic neoplasms is mainly a product of decomposed acids and cholesterol.
As you know, some cases of interrupted ectopic pregnancy present great difficulties for the diagnosis and, according to the information, we can say that the chapter on the diagnosis of ectopic pregnancy is replete with descriptions of various diagnostic errors. In this message, we would like to outline the techniques, mainly laboratory research methods, that we use in our clinic in these difficult cases. Of particular interest in recent years is the use of the so-called pyramidone test for hematin in ectopic pregnancy (Antoshina, Baksht, Zhivatov, Ivanov, Pobedinsky, Mandelstam, Povzhitkov, Wermbter, Haselhorst, Thormähten, Arons, Semenov, etc.) among gynecologists.
Our case of corneal papilloma concerns a peasant of the Sviyazhsky canton of the Tatrepublika B., 62 years old, who came to an outpatient appointment on 28 / VII of 1926 for a disease of the left eye.
There are currently many works on the study of blood morphology in both Russian and foreign literature, and the main attention is paid to the state of white blood, which most vividly reacts to all changes occurring in the sick body.
Before Guldshinsky discovered the importance of ultraviolet rays in protecting and treating the body from rickets, fish oil had long been considered the most reliable remedy for the latter.
Recently, we have observed the following interesting case in the Psychiatric Clinic of Kazan University.
Among all medical and sanitary workers, one of the first places in terms of difficult working conditions undoubtedly belongs to the staff of mental hospitals. The peculiar work environment, which consists in constant communication with the mentally ill, is the cause of many special moments of professional harmfulness of work, of which the great traumatization of the medical staff deserves special attention. At the suggestion of the Central Medical Committee, we carried out, according to specially developed maps, the registration of injuries of medical workers of the Kazan district psychiatric hospital for the time since April 1, 1928. on April 1, 1929 A relatively small number of injuries during this period (175) This is explained by the fact that at the beginning the registration was not conducted accurately enough, and only in recent months, thanks to a number of measures taken, it has improved. The following can serve as an illustration: on average, 9 cases of injuries fall for each of the first 7 months, and 23 cases for each of the last 5 months. The last number should be considered closer to the truth. However, until the very end, the registration remained far from complete, since only more or less severe cases were registered, where there were objective signs of damage: wounds, scratches, burns, etc., which were checked by a doctor. Other cases, such as light blows, pushes, various insults. they were not noted at all, because the medical staff, firstly, did not attach any importance to them, considering them to be ordinary and absolutely inevitable phenomena of their profession, and, secondly, the staff on duty did not have enough time to register these mild cases of injuries, which were too frequent.
Forensic medical examination should be based on accurate scientific data obtained through experience and observation. In cases where the examination concerns issues that do not have sufficient experimental justification, we have to resort to an experiment to confirm our conclusion.
Since the work of Kgomresheg, groups of cancers have been identified under the name Basalzellenkrebs, which originate from the basal cells of the multilayered epithelium of the skin and mucous membranes of various organs. Borrmann avoids this name, considering it incorrect. Considering the epithelium in its embryonic differentiation as a whole, and the process of keratinization in the upper layers as a physiological process of renewal, he does not see the possibility of attributing to the epithelium in its individual layers different biological properties in the sense of the morphology of tumors originating from different layers of the epithelium. The question, in his opinion, can be solved in a positive sense if we accept the statement of Schapert and Cheps about the presence of cell complexes in the entire epidermis that remain at the embryonic stage of development. He divides skin cancers into squamous-epithelial, keratinizing (cancroid) and non-keratinizing or atypically keratinizing squamous-epithelial (parakeratous) cancer. Lauche produces these cancers throughout the intestinal canal from embryonic epithelial sites that remain completely undifferentiated. Histologically, these cancers are constructed from large-spindle cells, poor in plasma, with a nucleus rich in chromatin. In their structure, these cells are similar to the elements of the main layers of the epithelium of the skin and mucosa, rarely undergoing further differentiation in the form of keratinization and mucus formation. Dusshl notes some characteristic features of the structure of this cancer in the stomach: in the outer rows of the tumor, the cells have a cylindrical shape, the inner ones are egg-shaped and fusiform. It is often possible to see round glandular lumen in cancerous areas. Localization of these tumors: the skin of the face, nose, lips, hard palate, laryngeal mucosa, trachea, bladder, esophagus, intestines, appendix. A case of basal cell carcinoma in the stomach is described only by Duschl.
14 / XII On 26, b-noi V., 36, was admitted to the Nachenal district hospital, sent for surgical treatment for intestinal inversion.
Treatment of pulmonary tuberculosis goes in two ways: one is conservative, and the other is surgical. The principle of both treatments is to excite and strengthen the immune-biological forces of the body, which is achieved by the relative rest of the diseased organ. In recent years, the treatment of pulmonary tuberculosis by cutting or twisting n. phrenici has been put forward. This method has earned the trust of the German school (Sauerbruch, Harry, Brauer), taking a prominent place in the treatment of tbc of the lungs. In Russia, frenicotomy is not yet widely used, and therefore the case of injury n is not uninteresting. phrenici, which resulted in paralysis of the diaphragm in a patient suffering from an exudative form of the left lung.
The reason for writing this work was the observation of 49 patients with widespread burns who have passed through the surgical department I am in charge of over the past 3 years.
During the operation of an inguinal hernia, I had to come across an encapsulated concretion the size of a goose egg in the abdominal cavity, near the internal inguinal canal (see photos). Due to the interest of the case, I will briefly report the medical history.
Patient B., 34 years old, was taken to the Marxstadt Hospital on 21/XII 27 with severe pain in the lower abdomen and told the following. On the night of December 18-19, the patient was drunk in the company, in the morning he had a hernia, which he did not pay attention to at first, the hernia came out earlier and descended into the scrotum (it was the size of a goose egg).
Light treatment in dermatology originates from Finsen, whose method is widely used. The Finsen device has found application mainly in the treatment of skin tuberculosis and especially lupus vulgaris, where positive results are obtained. But the high cost of the device and its complexity caused an attempt to use other light sources for treatment. Among the latter, a mercury-quartz lamp is currently enjoying great success, which has found application in the treatment of many painful processes, including skin diseases. In the West, the light of a quartz lamp is used by many dermatologists (Kromayer, Jesionek, Schmidt, Nagelschmidt, Stümpke, Hümphris, Lancaschir, Castle, Sibley) for the following skin diseases: alopecia areata, lupus vulgaris, acne vulgaris, acne rosacea, eczema, furunculosis, dermatitis, etc. As far as we know, there are only a few observations on the use of quartz in the Russian dermatological literature. Our clinic, having considerable material on the treatment of mercury-quartz lamp, mainly for diseases of the nervous system and internal organs, also has some material, although not yet numerous, in the field of skin diseases.
If until now the functions of individual elements of the ovary have not been clarified with sufficient certainty and the mechanism of action of its internal secrets is not yet completely clear, yet at present considerable factual material has accumulated that makes it possible to somewhat characterize the internal secretion of the ovaries in their influence on the organs of the sexual apparatus and on the entire body of women. In the ovary of a sexually mature woman, three formations may be important for its intersecretory function: the yellow body, the follicular apparatus and the interstitial gland. The temporary appearance of the yellow body, in the form of corpus lut. menstruationis and its long-term persistence during pregnancy in the form of corpus lut. graviditatis has long attracted the attention of many researchers and pointed out its functional significance. After Vogp and Prenant expressed the view that the yellow body is a gland with internal secretion, this question began to be developed by a number of researchers. At present, based on the large amount of experimental data available in the literature, obtained both on animal and human material, it is possible to point out some provisions that are more or less generally recognized.
"Natural Science and Marxism". Magazine (4 times a year for 12-15 pages, each book). Ed. "Sections of Natural and Exact Sciences of the Communist Academy". Editor-in-chief O. Y. Schmidt. Ed. 1929, Nos. 1 and 2. Price per year 7 rubles 50 kopecks.
A small book (211 pages) presents clinical lectures covering the most important nervous diseases in children: chapter I-inflammation of the meninges; chapter II-Heine-Medina disease and other acute diseases; chapter III-chronic brain diseases (head dropsy, tumors, cerebral palsy, dementia); chapter IV-epilepsy, spasmophilia, etc., seizure diseases; chapter V psychogenic diseases. The last chapter, without corresponding to the title, briefly covers the most diverse pictures of reactive and constitutional neurotic and psychopathic manifestations.
Questions of social hygiene, physiology and pathology of children's age. Edited by N. F. Altgausen, A. I. Balander, S. O. Dulitsky, R. O. Lunts and A. S. Sokolov. Library "Protection of Motherhood and Infancy", Gosmedizdat. Moscow, 1929, the price is 4 rubles.
In session 5/II—29, the bureau of the section was re-elected. Prof. V. V. Miloslavsky was elected as the Chairman, Dr. I. A. Kondakov as the deputy and Dr. L. I. Los as the secretary. Session 26 / III 29
New in defectology-Collection (the first) edited by prof. A. S. Grimoyedov (Proceedings of the Defectological Department of the State University. of the Psycho-Neurological Academy with the State Reflexological Institute), Leningrad, 1928.
The collection concludes on 339 pages 16 articles by various authors-prof. A. S. Griboyedov and his staff. The primary content of the articles is the development of methodological issues. A large article by Yu. A. Levin describes in detail "mass methods of studying the giftedness of schoolchildren and up to schoolchildren of normal and special groups" with the application of separate research schemes, M. M. Shershen gives an interesting attempt to build a social diagnostic profile, in the work of Dr. E. S. Nikitina and V. V. Reinhardt, the well-known Downey method (tests for the study of the "volitional process") is tested and evaluated. Other articles conclude the development of narrower issues of both diagnostic (the Vissaipo reaction, the Bine method in patients, capillaroscopy, etc.) and therapeutic order (treatment of stuttering according to E. Freschels, infusion of collargol for metencephalitic changes in the psyche, treatment and prevention of hypothyroidism). Abstracting all these articles here is impossible due to the abundance of the material being concluded.
V. K. Trutnev announced the death of the Honored Scientist, Professor N. A. Mislavsky. The assembly honored the memory of the deceased by standing up.
Physiotherapy section.
1st meeting 24 / IV-29