Since 1864, a number of reforms have been carried out in Russia. With the establishment of the zemstvo, the order of public charity was liquidated, and the zemstvo, provincial, county, and city councils began to be in charge of the people's health. Zemstvo medicine has played a significant role in serving the rural population.

In pre-revolutionary Russia, there were about 300-400 doctors-specialists in ear, throat and nose diseases, who had about 200 beds at their disposal. Departments of otorhinolaryngology were only at the Military Medical Academy, at the Higher Women's Medical Courses, at the Clinical Institute for Advanced Training of Doctors, at the medical faculties of Moscow and Saratov Universities. Advanced training of doctors was carried out only at the clinical institute, opened in 1885. in St. Petersburg, and even then in a very limited number of disciplines (in particular, the office for ear diseases was opened only in 1889). Of course, with such a state of affairs, there could be no question of any effective otorhinolaryngological services for the population of the country.

Cardiac asthma is most often observed with hypertension and atherosclerotic cardiosclerosis and much less often with heart valve defects. In our patients (148), we met it in isolated cases with syphilitic arthritis, acute and chronic nephritis.

Over the past 15 years, resection phthisiosurgery has gained recognition and is widely used in the complex treatment of pulmonary tuberculosis. However, with lung resection, various complications occur in the postoperative and long-term period. Of these, the most dangerous and severe are pleural empyema, bronchial fistulas, exacerbations and relapses of the tuberculosis process. According to domestic and foreign authors, the frequency of complications ranges from 2 to 30% [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 13 Prevention and treatment of complications are urgent problems in the surgery of pulmonary tuberculosis.

In most patients with pulmonary tuberculosis, timely surgical treatment gives good and even excellent results. However, complications that worsen the course of the postoperative period are still not uncommon. If we exclude the outbreak of a specific process in the operated lung and on the opposite side, then the most formidable complication is the development of pleural empyema.

Recently, so-called partial, or economical, lung resections have been increasingly introduced into surgical practice. Various kinds of combined resections, mono-, bi- and trisegmentectomies have replaced the previously inevitable pulmonitis lobectomies.

Despite the success of pulmonary surgery, there is still a large number of refusals from operations due to the prevalence of the pathological process in the lungs and low indicators of the function of external respiration [4, 6]. According to some authors, complete recovery after radical surgery occurs in 70-80% of patients [9, 12, 16, 17]. The rest of the patients after the operation continue to make various complaints, most often for coughing with sputum, periodic fever.

Domestic authors pay considerable attention to the "masks" of tuberculosis, which is associated with the difficulties of their diagnosis [2, 3, 4, 5, 7]. Masked forms of tuberculosis are locally limited processes occurring with syndromes characteristic of non-tuberculosis diseases. Most often, these forms are observed in primary tuberculosis, especially in its chronic course. Chronic primary tuberculosis, first described by V. T. Shvaytsar, is a peculiar form of bronchoadenitis and is characterized by the presence of calcification sites and significant caseous changes in the affected lymph nodes, which serve as a source of prolonged intoxication and sensitization of the patient's body.

With prolonged chemotherapy of tuberculosis patients, side effects often occur. A well-known part of them is associated with metabolic disorders of complex B vitamins.

Blood transfusion in pulmonary tuberculosis has long been considered contraindicated for fear of causing an exacerbation of the process. The first report on hemotransfusions in patients with pulmonary tuberculosis for hemoptysis appeared in 1935 [11].

We observed patients with upper quadrant reflected syndrome, which arose in connection with lung pathology. 45 of them (40.9%) had reflected headaches in addition to other algic signs of repercussive syndrome (pain in the upper arm, shoulder joint, arm, chest, etc.). In 60%, they resembled hemicrania and coincided with the side of the pleuro-pulmonary process with its unilateral localization, in the rest they were diffuse, but clearly dominated in intensity on the side of the affected lung. By nature, they were pulsating, aching, aching; they usually occurred in the occipital region and spread anteriorly to the parietal, less often the frontal region; sometimes they were given to the eye or ear. In half of the patients, they intensified with sudden head movements or, conversely, with prolonged forced head position. In 32 patients, kefalgia was combined with noise in the head or ears (according to the type of objective ear noise). In addition, 12 patients complained of dizziness, but only 2 had systemic dizziness, the rest experienced a feeling of nausea, uncertainty when walking, etc. 12 patients with headache companions had visual disturbances, expressed in periodic darkening in the eyes, a feeling of shroud or fog in front of the eyes, flickering of flies or black dots. Soreness of typical vegetative algic points on the head and neck was noted: supraorbital [7], vertebral artery [22]. As a rule, the temporal reflex of S. S. Vermel (1929) turned out to be positive. Thus, the violations listed above were clearly of vegetative-vascular origin.

Hemodynamic disorders in the pulmonary artery system are leading in the development of the pulmonary heart, however, it is often not possible to identify them based on clinical symptoms and generally accepted methods of examination (X-ray, ECG, etc.).

The intratracheal method of inhalation anesthesia has become widespread. However, with it, complications are not uncommon both in the early and late post-acute periods.

In 1932, Prof. B. L. Mazur, growing a "blue stick" in broth, devoid of the acid resistance of the Koch stick, for the first time received an atuberculin antivirus. The "blue wand" and the classic tuberculous mycobacterium do not grow in B. L. Mazur's antivirus. In its environment, the antivirus does not contain tuberculin, it withstands sterilization in an autoclave well. These specific properties of the antivirus made it possible to use it in the clinic. In patients with extrapulmonary tuberculosis treated with this drug, manifestations of concomitant diseases, in particular bronchial asthma, disappeared. Annually by the antivirus of Prof. B. L. Mazur treated 50-60 patients suffering only from bronchial asthma.

This paper presents the results of a comprehensive study of violations of gas exchange in the lungs (in terms of lung volumes, uniformity of distribution of inhaled gas, diffusion of gases in the alveolo-capillary system of the lungs), deviations of alkaline-acid equilibrium, the effect of CO2 on the respiratory center (by the increase in pulmonary ventilation), on the accumulation of CO2 in the inhaled air (by the method of return respiration). The research was carried out using domestic devices: a closed-type spirograph A-M, an azotograph A-1, a low-inertia gas analyzer GUM-2, an oxyhemograph 0-36, an apparatus for measuring hydrogen ions AZIV-1.

Despite the widespread use of bronchography in bronchopulmonary diseases, the question of the possibility of hypoxia during bronchial tree contrast has not been sufficiently studied.

The central position occupied by the liver in metabolic processes determines its secondary defeat in various pathological conditions of the body. For a sufficiently complete understanding of these changes, it is necessary to study not only functional abnormalities, but also morphological damage to liver cells. In this regard, the method of puncture liver biopsy has recently become widespread, which allows to identify the initial forms of liver damage, to make dynamic monitoring of the course of the pathological process, to detail the diagnosis.

The question of the etiology and pathogenesis of polyps and polyposis of the colon has not been clarified. There is no consensus in the literature on the role of inflammatory processes in the digestive tract and the colon itself in the genesis of polyps.

Due to the polymorphism of abdominal pain syndrome, tuberculous mesoadenitis refers to difficult-to-diagnose diseases. It often occurs under the "mask" of chronic appendicitis and other diseases of the abdominal cavity. The cause of various digestive disorders accompanying tuberculous mesoadenitis are combined disorders of the function of various digestive organs.

Diseases of the gallbladder and biliary tract in children are observed quite often.

The functional state of the adrenal cortex in patients with severe primary toxic goiter was judged by the content of 17-oxycorticosteroids (ACS) and 17-ketosteroids (17-CS) in the daily amount of urine, which were examined respectively by the Porter and Silber method modified by M. A. Krekhova and modified by O. M. Uvarovskaya by the Zimmerman method. In all patients, the basic metabolism was determined using the AOOZ-M apparatus of the Kazan Plant of Medical Equipment, and in some of them, in parallel, also according to the Gele and Breitman formula.

Ocular hypertension with a lesion of the hypothalamus differs from true glaucoma in the preservation of vision, the absence of glaucomatous excavation of the optic nerve disc, in some cases poor tolerability or inefficiency of myotics. This symptom in some patients preceded the appearance of other signs of damage to the hypothalamus, while in others it was the only symptom of the disease.

The modern stage of otosclerosis surgery is characterized by the widespread use of radical operations on the stirrup. Allowing in almost all cases to restore the disturbed mechanism of sound transmission, these operations are accompanied by a reaction of the inner ear, the severity of which ultimately determines the functional effect of the operation.

Evaluation of radiographs of the pyramid of the temporal bone is of particular importance in connection with the introduction into practice of methods of surgical treatment of many forms of hearing loss. The lack of precise objective criteria for determining the degree of pathological rarefaction or compaction to which the temporal bone is exposed during the development of the otosclerotic process reduces the possibility of sufficiently accurate diagnosis and, moreover, predicting the effectiveness of the operation. The visual assessment of the density of the pyramids of the temporal bones on radiographs is not objective enough and depends largely on the experience of the doctor.

Questions of etiology, pathogenesis and treatment of weakness of labor activity are of paramount importance to date, especially during childbirth in the pelvic presentation. A necessary condition for the birth of a healthy child with pelvic presentation is the presence of good labor activity. Meanwhile, when studying the slow bioelectric activity of the uterus (BAM) by the method of G. M. Lisovskaya (1963), we found that the functional activity of the uterus during pelvic presentation of the fetus at the end of pregnancy is significantly reduced. The overall level of BAM as an indicator of quantitative measurement was on average equal to 34.7 conventional units in primiparous, 30.3 in repeat—bearing, while 65 and 50 respectively in head presentation. Consequently, the appearance of weakness of the expelling forces in childbirth is not accidental, but is due to the functional inferiority of the uterus that occurs at the end of pregnancy.

Ethanolamine has great biological activity. With his participation, protein synthesis is carried out, the activity of enzymes increases, redox processes occur more intensively. The influence exerted by ethanolamine on phosphorus metabolism is very important. G. V. Kamalyan and G. V. Barseghyan showed in an experiment that under the action of ethanolamine, phosphorus excretion in urine decreases due to increased reabsorption in the renal tubules with its subsequent accumulation in various organs. At the same time, the activity of alkaline and acid phosphatases in blood plasma increases markedly [4].

The role of viral infections in the pathology of the visual organ is becoming increasingly important. The etiological role of viruses in diseases of both the outer membranes of the eye (trachoma, conjunctivitis, keratitis) and in diseases of the inner membranes of the eye and the visual pathways (iritis, iridocyclitis, optic neuritis, etc.) has been clarified.

In this work, the task was set to study the change in the activity of antitumor drugs under the influence of those substances with which they come into contact when injected into the body. It should be noted that the work in this direction in relation to antibacterial drugs [2] has proved to be very fruitful.

In the pre-antibiotic period, the average life expectancy of patients since the development of the cavern usually did not exceed 5 years. A modern clinic accumulates materials for the treatment of cavernous tuberculosis. However, the nature and dynamics of residual changes formed at the site of former cavernous processes, especially after chemotherapy, in the long-term follow-up, are still insufficiently elucidated.

In an effort to improve the effectiveness of treatment of tuberculosis patients, clinicians have been increasingly using increased therapeutic doses of GINK drugs in recent years. Many researchers, both in experimental and clinical observations, have found the advantage of high doses of tubazide over low ones [8, 10, 11], In this regard, there has been a tendency to use tubazide 0.3 three times, i.e. 15-20 mg/kg, even in broad clinical practice. Meanwhile, such a dose in the world literature is considered high, often leading to toxic reactions. Based on the materials of Biehl and co. (1954), Costelletos and co. (1954), Benda and co. (1954), a side effect when using isoniazid at a dose of 16-24 mg / kg is observed in 28-44% of cases. At the same time, the data on the therapeutic advantage of high doses cannot yet be considered indisputable, since there is a message about the absence of an additional effect with an increase in the amount of the drug administered [7]. The purpose of this study was to study the nature and frequency of side effects of tubazide, used 0.3 3 times a day, compared with average doses and the possibility of preventing toxic-allergic reactions with pyridoxine. There were 807 patients with fresh and chronic forms of pulmonary tuberculosis under observation (age - from 18 to 68 years). 210 people received tubazid 0.15 3 times a day and 597 - 0.3 3 times a day in combination with other tuberculostatic agents of the I or II series. Some patients receiving high doses of tubazide were given pyridoxine to prevent side effects.

In the development of chronic pneumonia, along with other factors, a change in the reactivity of the body is of great importance. The literature data on immunological reactivity in prolonged and chronic pneumonia are contradictory. K. V. Temirova, Y. N. Marmur, N. B. Grinbaum, E. V. Balitskaya found an inhibition of immunological reactivity. M. P. Matveev writes about the absence of significant shifts, and L. R. Vatagina, G. F. Mashirova observed an increase in reactivity in chronic pneumonia.

The most common malformations of female genital organs are hymenal and vaginal atresia. In most cases, they are congenital and do not manifest themselves before the onset of menstruation, but they can also occur as a result of injury. With the development of menstrual-ovarian function, menstrual secretions do not find their way out and accumulate, forming hematocolpos, hematometer, hematosalpinx. Overflow and overextension of the internal genitals cause the appearance of abdominal pain during periods corresponding to the onset of menstruation.

Despite the fact that the perforation of gastric and duodenal ulcers has been known to doctors for about 120 years, its diagnosis is difficult in some cases, and diagnostic errors are not uncommon.

Appendicular infiltrate is a frequent complication of acute appendicitis.

We observed 50 patients aged 15 to 70 years. There were 15 people with prolonged acute pneumonia, 15 with bronchial asthma, 11 with chronic interstitial pneumonia, 9 with pneumosclerosis. There were 23 men, 27 women. Patients with chronic interstitial pneumonia also suffered from bronchiectasis, often multiple, with periodic exacerbations. Bronchial asthma in 15 people was accompanied by severe attacks in recent years, in a number of patients it was complicated by pneumosclerosis in the stage of emphysema and bronchiectasis.

Recently, intravenous hormone-chemotherapy has become widely used in patients with chronic forms of pulmonary tuberculosis. At the same time, the authors pay little attention to possible allergic and toxic complications that occur with intravenous administration of antibacterial drugs, and in particular tubazid.

Allergic history indicates that in patients with pneumosclerosis with asthmatic bronchitis and attacks of suffocation (90 people, group I) and their relatives, allergic diseases are more common than in patients with pneumosclerosis without pronounced bronchospasm (90 people, group II).

In our 25-bed pulmonary surgical department, bronchological examinations have been used since March 1965. 236 bronchoscopes have been performed on 204 patients aged 8 to 77 years. All bronchoscopies were performed under anesthesia.

The occurrence of spontaneous nonspecific pneumothorax is associated with degenerative fibrous changes in the interstitial tissue, mainly in the cortical parts of the lung, leading to a violation of the elasticity of the lung tissue with the formation of blisters. The rupture of such a bubble is the cause of spontaneous pneumothorax. The basis for the development of fibrous changes is a violation of the blood supply to the cortical parts of the lung. For the purpose of revascularization of degenerative atrophic parts of the lung in 1954 pleurectomy was performed with simultaneous removal of altered lung areas with spontaneous nonspecific pneumothorax with a good result.

A 16-year-old patient was taken to the surgical department on the night of 16/III 1949 for a blind gunshot wound to the chest, in a state of shock. The entrance wound is located in the area of the heartbeat. Medical assistance was immediately provided, but surgical intervention was not shown. After 6 weeks, the patient was discharged in good condition. Among the residual symptoms, coughing attacks were noted when standing on the right side.

Since 1959, we have used aeroionotherapy for a number of diseases.

Currently, a significant part of the operations are performed in the patient's side position. Turning it into this position after induction into anesthesia and intubation may be accompanied by postural circulatory reactions up to cardiovascular collapse. The latter is most often found in patients with lesions of the spinal cord and spine, with cardiovascular diseases. Postural circulatory reactions are especially pronounced with potentiated anesthesia. In order to prevent them, Sanchez-Salazar and Burstein (1959) proposed intubating patients who are going to undergo surgery in a side position in the same position. However, we could not find coverage of a number of issues related to the use of this method of intubation in the literature.

We have not found any reports on the course of pregnancy and childbirth after liver resection for tuberculosis.

Nonspecific ulcer of the small intestine in the Russian literature was first described by S. M. Rubashov in 1928. The relative rarity and acute course of the disease requiring emergency surgical intervention explains our scant information about the etiology and pathogenesis of this type of pathology.

The patient is placed on the operating table in a horizontal position face down with his arms outstretched. The arms are bent at the elbow joints and placed under the head, which contributes to the removal of the shoulder blades forward. A roller is placed under the abdominal wall to align the lumbar and thoracic spine. Prepare the surgical field from the corners of the shoulder blades to the lower lumbar spine. There are two points of the site of the introduction of novocaine with a preliminary formation, lemon nodule. The needle is installed perpendicular to the VI intercostal space, retreating 2 cm to the right of the spine, and along the lower edge of the VII rib is pushed deeper with a preliminary injection of 0.25% novocaine solution in front of it. When the needle reaches the intercostal muscles, there is a slight increase in the obstacle and difficulty in introducing the solution. Having advanced the needle by 0.3-0.5 cm, we approach the parietal pleura. In this department, the solution flows more freely. When the pleura is irritated, a cough reflex appears, but this happens very rarely, since the injected novocaine anesthetizes the pleura, and the reflex does not occur.

In No. 5 of the Kazan Medical Journal for 1968, a small note by N. I. Pushkarev on the diagnosis of rib fractures was published.

Reconstructive operations of the abdominal wall with large postoperative hernias present significant difficulties for the surgeon.

We neurologically examined 91 men and 144 women with shingles. 123 of them were treated on an outpatient basis, 112 - inpatient. The disease was observed in people of all ages (from 3 to 90 years), but most of the patients were over 50 years old. 78 people got sick in winter, 72 in autumn, 56 in spring, 29 in summer.

I., 40 years old, was admitted on 7/V 1968 for a tumor of the abdominal cavity.

Since the exchange of acid mucopolysaccharides is disrupted in rheumatism, it seems advisable to study the release of glucuronic acid in the urine in this disease.