In the expressed form of avitaminosis, we are now observed less and less. Nevertheless, the problem of vitamin deficiencies remains relevant for the practitioner. As the physiological role of vitamins and their importance in pathology becomes more and more clear, the presence of light, "erased" forms, which are more correctly called hypovitaminosis, becomes more and more obvious. Experience shows that the generally accepted ideas about the conditions for the occurrence of avitaminosis should be revised. Not only in the absence or in the absence of one or another vitamin in food, vitamin deficiency can develop. More and more observations are accumulating showing that a weak or even strongly pronounced vitamin deficiency can appear in a person who receives a completely complete diet. This phenomenon, paradoxical at first glance, can take place under the following circumstances: with digestive disorders associated with impaired absorption; with liver diseases (the latter is especially important for vitamin A deficiency, since the conversion of carotene into vitamin A suffers); when the need for vitamins is increased against the norm, for example, in rapidly growing children or in lactating women who excrete significant amounts of vitamin C with milk; with increased destruction of vitamin stores in the body, which is observed with all kinds of infections and other febrile and debilitating diseases. To what has been said, it must also be added that very often our food turns out to be poor in vitamins, due to irrational preparation, improper storage of food, peculiar deviations of appetite, etc. In the earliest stages, when even mild clinical symptoms do not yet exist, modern methods of studying vitamins can the presence of latent hypovitaminosis. This is especially evident in the example of the scourge.
Clinically, with nephrosis, we observe edema, albuminuria, lipoiduria, which, as follows from the data of modern clinics, along with changes in the kidneys, largely depend on the general suffering of the body — disorders of protein and lipid metabolism. Indeed, studies have established that with nephrosis there are deep biochemical shifts - a decrease in blood plasma proteins, a change in the ratio of the protein fraction of the blood towards globulins, an increase in the content of fibrinogen, uric acid, a decrease in osmotic pressure and, finally, in parallel with a change in protein metabolism and changes in fat-lipoid metabolism - hypercholesterolemia.
The study of the problem of water exchange and issues of the pathogenesis of edema (Starling, Krog, Beilis, Schade, Gover, Shabanier, Kilin, etc.) made it possible to establish the colossal significance in the pathogenesis of nephrosis of a number of factors associated with the state of the body's proteins. To one degree or another, depletion of blood plasma proteins, sharp changes in the ratio of protein fractions with a shift towards the coarse-dispersed phase (globulins), an increase in the hydrophilicity of tissue colloids (McClure and Aldrich test) characterize pathological shifts in the protein economy of the body. The osmotic pressure of nephrotic plasma proteins drops sharply due to an increase in osmotically much less active globulins and fibrinogen (Schade, Shabanier, Gover, Kilin, Malkin, etc.). This decrease can in some cases reach a value of 10-14 cm of water column in comparison with the normal value of 30-40 cm (Gover, Golikov). According to modern views, these violations of the protein constant due to changes in the salt balance, in the state of permeability of the capillary wall and the state of tissue colloids are a common cause of the hydropic state of the body. Along with the violation of protein metabolism, changes in the state of lipoid-cholesterol metabolism occur in the body with nephrosis. The absence of contraindications for giving nephrotic protein is well known.
Until now, a significant part of doctors adhere to some old dietary traditions, or rather "dietary prejudices." Since rational nutrition for hepatitis is the leading therapeutic measure, it seems to us timely to highlight the question of how to build a table for a patient with acute parenchymal hepatitis. We treat here acute parenchymal hepatitis because rational therapy in general and diet therapy in particular is that powerful factor that in many cases can predetermine the further course of events: acute hepatitis with rational therapy can be eliminated and, conversely, with irrational therapy, it can a state of pre-cirrhosis and even cirrhosis. In light of the modern doctrine of dyshergy or allergy (according to Reesle patergy), these various outcomes of acute hepatitis become completely understandable, since they (outcomes) depend on the degree and strength of the response of the hepatic cell sensitized by endo or exogenous poison to one or another allergen.
In the pathology of the stomach and intestines, constitutional factors play a prominent role (enteroptosis, coecum mobile, etc.). In particular, persons with habitus enteroptoticus are predisposed to all kinds of functional diseases of the gastrointestinal tract (atony of the stomach and intestines, etc.).
Recently, we have a number of reports on the use of ammoniacal compounds of silver in the clinic of surgical and gynecological diseases in various inflammatory, purulent and septic processes. The authors of these reports ascribe a strong antiseptic, bactericidal effect to ammonia solutions of silver in comparison with other drugs.
Of all the methods of treating epidemic meningitis, the method of serotherapy has acquired the greatest relevance. Despite the fact that the issue of serotherapy is already 30 years old, it has not yet received final resolution. A number of authors who have used serum in our country in recent years could not confirm the benefits of serum treatment. All this put before the institutes producing anti-meningococcal sera, the question of titrating them and the titration method itself. “The problem of serotherapy of cerebrospinal meningitis is, first of all, a problem of the method of titration of anti-meningococcal serum” (Prof. Zdrodovsky).
The beneficial therapeutic effect of a febrile process on the course of meningo-myelitic, meningo-encephalitic and encephalitic diseases has long been noted. The positive effect of hyperthermia on the course of these diseases in children is especially emphasized. A number of authors also note the beneficial effect of experimental hyperthermia on the course of infectious chorea. To induce hyperthermia, some authors used the introduction of nirvanol or lac. sulfuris (Revash), others - intravenous injections of typhoid polivaccine (Setton), finally, the third observed the effect of acute febrile infections on the course of chorea (Zalkind, Fox). As a result of hyperthermia, most authors note frequent relief of chorea. A clinic in Vienna has tried to treat post-encephalitic parkinsonism with malaria vaccinations, with negative results.
In 1929, Professor A.V. Vishnevsky proposed the treatment of spontaneous gangrene by anesthesia of the perirenal space with a novocaine solution used in surgical operations. Such anesthesia, according to prof. AV Vishnevsky, was supposed to have an anesthetic effect on the nervous system of the adrenal gland. It meant that the effect after removal of one adrenal gland according to Oppel in spontaneous gangrene does not depend on a decrease in the accumulation of adrenaline in the blood, but is associated with mechanical blockage of the adrenal gland during surgical, rather traumatic intervention.
In this article, we decided to share the data that we obtained in the study of perforated stomach and duodenal ulcers based on material from the surgical department of the Nechaev Obukhov hospital in Leningrad, for which purpose we used the surviving case histories, hospital reports, protocols of scientific meetings of doctors hospitals and hospital staff printing.
Introduced into surgical practice by Lister, catgut quickly became an integral part of surgical use, and it has not lost its significance to this day. Despite all the power of modern asepsis, surgery even now cannot do without absorbable material for sutures and ligatures, since non-absorbable material, being a foreign body, remaining in the body, can cause a long-lasting inflammatory process in the surrounding tissues. In practice, each surgeon has to observe patients with long-term non-healing fistulas formed as a result of expelling silk or thread ligatures.
Special attention is paid to the issue of wound treatment by surgeons. Many different ways, methods and drugs for the treatment of purulent wounds have been proposed. In 1934, Lair published his original method of using fish oil for the treatment of wounds, which captivated many surgeons with its effectiveness, simplicity and availability. We use Laer's method for about one and a half years with some modification. We, using the suggestions of Gollyander, Leffler, Nuzelaum and others (I quote from Kapitsa), widely use pure humanol for the treatment of purulent wounds of the most varied in their genesis, localization and bacterial flora. We also use humanol as a basis for some chemical ingredients - iodoform, introducing it either as an emulsion in the treatment of bone tuberculosis according to Gotz-Grekov, or injecting it into bone cavities after trepanation of the bone with osteomyelitis lesions, fistulous passages, etc., often filling these cavities with a humane mass.
Human body resp. the animal is one whole, where all the individual parts are closely related and mutually influence each other. From this point of view, it is clear that there is a definite connection between gynecological diseases and diseases of other organs, and the source of the disease is not always localized in the diseased organ, but often outside it. So, it is well known that a disease of the organs of internal secretion, heart, lungs and other organs can cause disease of the female genital area.
Of the various changes in the body that occur during acute bleeding, changes in the rhythm of respiration are less studied. Meanwhile, the issue of periodic respiratory rhythm disorders in acute bleeding is of interest for the clinic in prognostic terms.
This article presents the results of work carried out by me in the laboratories of the pharmacological department of the Smolensk and Arkhangelsk medical institutes on dogs, as well as the results of the use of course subcutaneous injections of oxygen in some diseases in humans, obtained by a team of doctors working under my leadership (Keverovich E.I., Villert A.O., Yudenich V.A. and others) in the Smolensk hospital of the FZITK.