NOMENCLATURE AND CLASSIFICATION OF DISEASES — the list of names of the diseases accepted by medical science at this stage of its development and group of diseases by a certain principle.
The concepts «nomenclature» and «classification» are ambiguous. The nomenclature of diseases represents the extensive list, or the catalog, the standard names of the diseases or states used by doctors for the correct and uniform designation of diseases. Development of nomenclatures of diseases both international, and national, including in the USSR, is not ended yet. There are separate private nomenclatures on separate specialties which were not generally recognized still. In process of development of medical science the nomenclature of diseases and states extends due to inclusion of new terms, and all their list is exposed to review in connection with regular reviews of classification of diseases.
Statistical classification of diseases is understood as a certain system of distribution and association of diseases and patol, states in groups and classes according to the established criteria. There are many various approaches to classification of diseases. E.g., the pathologist can give preference to the classification based on anatomic localization of defeat whereas the practical doctor first of all is interested in the nature of disease process, the specialist in the field of health care — an etiology, the clinical physician — the specific displays of a disease requiring its attention. In the operating international classification (review of 1967) reflection found the compromise solution of various approaches to group, both the etiological, and pathoanatomical principle taking into account the main localization of a disease on bodies and systems is reflected in it.
Statistical classification of diseases is the management for systematization of observations during the studying of incidence and causes of death of the population, and also in activity of healthcare institutions. It is limited to a certain number of headings, to-rye cover all set patol, states. Each specific disease or patol. the state in classification takes certain place, the heading or a subheading. Classification is based according to sovr, the level of medical science, in it reflected the latest data on an etiology, a pathogeny, a wedge, to the course of separate diseases and patol, states. The uniform group of diseases provides comparability of statistical materials about incidence and causes of death not only for different spans, but also for various territories both in one country, and over the certain countries.
History of creation of classification of diseases
Attempts of systematization of diseases, creations of their classification were undertaken in an extreme antiquity. The first scientific classification of diseases based on progressive scientific views of 18 century was J. Morganyi's classification. The pathoanatomical principle of preferential localization of disease processes was its basis that distinguished it from the classifications of the past proceeding from idealistic and vitalistic concepts.
The first International statistical congress which took place in Brussels in 1853 charged W. Farr and D'Espina (M. d’Espine) preparation of «the uniform nomenclature of causes of death applicable for all countries». The following congress passing in Paris in 1855 accepted the compromise version of provisions of classification Farrah based on a combination of the etiological and lo-kalistichesky principles and D'Espin's classification grouping diseases in the nature of their manifestation (gouty, herpetic, thematic etc.).
Though this classification which was exposed to review in 1864, 1874 1880 and 1886, also did not become conventional, the principles of its creation formed a basis for the International Classification of Diseases (ICD). For its preparation International statistical charged in-t in 1891 to Bertilyon (J. Veg-tillon), to the doctor, the chief of statistical service of Paris to develop the MKB new project.
In 1900 at the first International conference on review of MKB which took place in Paris with participation of 26 states were accepted offered by Bertilyon the detailed list of causes of death consisting of 179 headings, and reduced — from 35 headings. Considering the progress of medical science leading to change of views of an etiology and a pathogeny of diseases the International conference, approving Bertilyon's project, passed the decision to reconsider MKB each 10 years.
The most essential changes in MKB were made by the conference on the sixth review convened by WHO, according to the Crimea new MKB entered action since 1948, at the same time the international agreement on a uniform method of selection the main, or initial, a cause of death was for the first time reached. Along with it the uniform form of the International certificate on a cause of death was approved.
In Russia the first attempts of creation of the nomenclature and classification of diseases belong to the famous clinical physicians — to M. Ya. Mudrov and I. E. Dyadjkovsky and belong to the beginning 19 in j Due to widely carried out territorial a dignity. the organization by studying of incidence the big contribution to preparation of statistical classification of diseases is made by the commissions under the leadership of P. I. Kurkin and E. A. Osipov.
In 1899 the VII congress Ob-va of the Russian doctors in N. I. Pirogov's memory for the first time approved the draft of the nomenclature and classification of diseases. This statistical classification which received Pirogovskaya's name was constructed generally on etiol, to the principle and contained 20 classes and 458 headings. All further works in Russia on review of classification of diseases were conducted on the basis of this classification.
Except Pirogovskaya, in Russia there was also official state classification. Existence of two classifications led to discrepancy between the All-Russian and territorial reporting on incidence. This situation was eliminated only after Great October socialist revolution. In 1918 official classification was cancelled and temporarily kept only Pirogovskaya. Then the work on its review and rapprochement with the international classification which ended with the approval in 1924 of the Soviet nomenclature and classification of diseases began, edges further it was reconsidered 4 times. After the last review (1952) the Soviet nomenclature of diseases consisted of 28 classes, 51 groups and 338 headings and was constructed by the mixed principle. She acted in the USSR till 1965 when in the country the International statistical classification of diseases, injuries and causes of death of the seventh review was introduced for the first time. Its careful studying showed what absence - whether - bo essential distinctions between domestic classification and MKB. Advantages of rapprochement of classifications were obvious, especially in connection with the increased role of the Soviet Union in the international relations.
Further improvement of classification of diseases was decided to carry out on the basis of MKB. The nek-ry specifications which are not breaking comparability of statistical materials were brought in the Russian option of MKB of the seventh review accepted for our country.
The international classification of diseases of the eighth review (1965) is approved by the XIX session of the World assembly of health care in 1966; in the majority of the countries came into force since January 1, 1968, in the USSR it is put into operation in 1970. The Soviet specialists constantly participated in its preparation.
The management but the International statistical classification of diseases, injuries and causes of death of the eighth review is published in two volumes, includes 17 classes (with discontinuous numbering of headings from zero to the 999th), the base methodical materials and index of diseases with the indication of headings of classification (the 1st volume).
The tree of classification in general breaks up to classes, groups, three-digit headings and four-digit subheadings. So, e.g., the II class «New growths» begins with the «Malignant New Growths of an Oral Cavity and Throat» group. This group begins with the heading «Malignant New Growths of Lips», edges, in turn, is subdivided into subheadings of «Upper lip», «Under lip», «Both lips», «The lip which is not specified». In total in this class of 9 groups, in the brought group of 10 headings, 7 of them are subdivided into 3 — 5 subheadings everyone. All this makes the detailed list of headings. In the 2nd volume of the management index of diseases and injuries, the index of the external reasons of injuries and the index of adverse reactions to pharmaceuticals and other chemical substances is presented. About 40 thousand terms are listed in these indexes, and not all from them meet the scientific requirements imposed to the diagnosis and are included in this list only owing to need to specify their place in classification even in case of not quite specified states.
Significantly the class «Diseases of the Blood Circulatory System» due to inclusion in it of the Vascular Damages of a Brain group changed in comparison with the seventh review, edges before entered the class «Diseases of a Nervous System». Considerable change was also inclusion in MKB of the term «idiopathic hypertensia» accepted in the USSR, to-rogo before in MKB was not. In the class «Mental disorders» according to the proposal of the Soviet psychiatrists the Psychoneuroses group was excluded and replaced by the Neurosises group with preferential vegetative disturbances. Diseases and causes of death in the perinatal period in this review are grouped generally in the nature of a disease of mother with division in forms of diseases or by types of injuries of a fruit. In the previous classification they joined in diseases of early children's age.
The international classification of diseases of the ninth review is accepted at the International conference of WHO, edges took place in 1975 in Geneva. According to the decision of the XXIX session of the World assembly of health care (1976) classification was included into action in the majority of the countries since 1978, in our country its introduction is planned for 1981 — 1982.
The structure and content of classification of this review, except for several sections, were left without change, in many sections the same headings remained, also the order of classes did not change. It became more detailed, practically all three-digit headings are subdivided on four-digit, and in nek-ry cases optional five-digit headings are entered (for designation of a diagnostic method of tuberculosis, a heating-up period of a diabetes mellitus, anatomic localization of diseases of a musculoskeletal system and diseases of connecting fabric, a method of conducting childbirth, the scene of nek-ry accidents).
The aspiration to increase flexibility of classification and a possibility of its use for carrying out a research of the multiple reasons of incidence and mortality led to inclusion in classification, in addition to diseases, considerable number of states, syndromes and even separate painful manifestations. Therefore classification carefully shall be used as an example during the writing of the diagnosis.
Classification has a number of features. The I class «Infectious and Parasitic Diseases» includes 3 headings of the remote effects of infectious and parasitic diseases. The combined headings, such, e.g., as «Tuberculosilicosis» are excluded. Classification of diarrheal states considers epidemiol. a situation in the country. The II class «New growths» includes all tumors, including functional and active, to-rye before treated endocrine diseases. There is additional morfol, a code (M-code) for group gistol, kinds of new growths. Morfol. a code — five-digit: the first four signs identify gistol. type, and the fifth sign — a behavior pattern of a new growth (malignant, high-quality). From the III class «Diseases of Endocrine System, Frustration of Food, Disbolism and Immunity» the nek-ry states connected with disturbances of immune mechanisms are moved to the IV class «Diseases of Blood and Hemopoietic Bodies». New to the V class «Mental disorders» — the glossary defining the maintenance of headings. The glossary is intended for the doctors establishing the diagnosis. Its introduction to classification promotes comparability of statistics of mental diseases in the different countries since the same diagnostic terms are quite often ambiguous according to contents. In the VI class «Diseases of a Nervous System and Sense Bodys» in one group hereditary and degenerative diseases are collected, neuromuscular diseases are carried to disturbances of a peripheral nervous system. The new subsection «Disturbance of Pulmonary Blood Circulation» is entered into the VII class «Diseases of the Blood Circulatory System». Instead of the combined headings on a condition of mother and a fruit in the perinatal period independent headings on each state separately are entered. Hemorrhages at a fruit and the newborn, to-rye connect with a pre-natal anoxia more now, than with a birth trauma, are allocated in an independent heading.
MKB recommends the special certificate on a cause of death in the perinatal period, a cut provides obtaining data both on diseases of a fruit or the newborn, and about diseases of mother that will allow to conduct in the subsequent the combined development of these materials.
The principle of double coding for certain diagnostic descriptions (about 15% of headings) is introduced for the first time. The system of double coding concerns only to those nozol, to forms, to-rye contain information both on an etiology, and on the local display of a disease which is of independent interest. E.g., tubercular meningitis has the traditional code on etiologies (class «Infectious and Parasitic Diseases») and the additional code in the place of manifestation (class «Diseases of a Nervous System and Sense Bodys»). The new code is used in the areas connected with planning, assessment of volume and quality of medical aid on separate medical specialties, providing: necessary communication between statistics of health of the population and statistics of activity of medical institutions. Appointment of group of accidents, poisonings and injuries for the external reason changed, the main classification included only the nature of damage.
The LIST of KLASSOV I GROUP WITH NUMBERS of the THREE-DIGIT HEADINGS ENTERING THEM (in brackets) the INTERNATIONAL CLASSIFICATION of DISEASES of the NINTH REVIEW
(according to the Guide to the international statistical classification of diseases, injuries and causes of death, volume 1, WHO Geneva, 1980)
I. Infectious and parasitic diseases
Intestinal infections (001 — 009)
Tuberculosis (010 — 018)
Bacterial zoonoza (020 — 027)
Other bacterial diseases (030 — 041) the Poliomyelitis and other viral diseases of the central nervous system which are not transmitted by arthropods (045 — 049) Viral diseases followed by rashes (050 — 057). The viral diseases transmitted by arthropods (060 — 066)
Other diseases, caused by viruses and chlamydias (070 — 079)
Rickettsioses and other diseases, transmitted by arthropods (080 — 088)
Syphilis and other venereal diseases (090 — 099)
Other diseases, caused by spirochetes (100 — 104)
Mycoses (110 — 118)
Helminthoses (120 — 129)
Other infectious and parasitic diseases (130 — 136)
the Remote effects of infectious and parasitic diseases (137 — 139)
II. New growths
Malignant new growths of a lip, oral cavity and throat (140 — 149) Malignant new growths of digestive organs and a peritoneum (150 — 159) Malignant new growths of a respiratory organs and a thorax (160 — 165) Malignant new growths of bones, connecting fabric, skin and a mammary gland (170 — 175)
Malignant new growths of urinogenital bodies (179 — 189) Malignant new growths of another and not specified localizations (190 — 199)
Malignant new growths of lymphatic and hemopoietic fabrics (200 — 208)
High-quality new growths (210 — 229)
Cancer of in situ (230 — 234)
of the New growth of uncertain character (235 — 238)
of the New growth of not specified nature (239)
III. Diseases of endocrine system, frustration of food, disbolism and immunity
Diseases of a thyroid gland (240 — 246) Diseases of other closed glands (250 — * 259)
Frustration of food (260 — 269)
Other disbolism and immunity (270 — 279)
IV. Diseases of blood and hemopoietic bodies (280 — 289)
V. Mental disorders
Organic states (290 — 294) Other psychoses (295 — 299) Neurotic disorders, psychopathies and other mental disorders of not psychotic character (300 — 315) Mental retardation (317 — 319)
VI. Diseases of a nervous system and sense bodys
Inflammatory diseases of the central nervous system (320 — 326) Hereditary and degenerative diseases of the central nervous system (330 — 337)
Other diseases of the central nervous system (340 — 349)
Diseases of a peripheral nervous system (350 — 359)
Diseases of an eye and its appendages (360 — 379) Diseases of an ear and mastoid (380 — 389)
VII. Diseases of the blood circulatory system
Rheumatism in an active phase, acute rheumatic fever (390 — 392) Chronic rheumatic heart troubles (393 — 398)
the Idiopathic hypertensia (401 — 405) Coronary heart disease (410 — 414) of Disturbance of pulmonary blood circulation (415 — 417)
Other heart troubles (420 — 429) Cerebrovascular diseases (430 — 438) Diseases of arteries, arterioles and capillaries (440 — 448)
Diseases of veins, absorbent vessels and other diseases of the blood circulatory system (451 — 459)
VIII. Diseases of a respiratory organs
Acute respiratory infections (460 — 466)
Other diseases of upper respiratory tracts (470 — 478)
Pneumonia and flu (480 — 487) the Chronic obturatsionny pulmonary disease and related states (490 — 496) the Pneumoconiosis and other pulmonary diseases caused by external agents (500 —-508)
Other diseases of a respiratory organs (510 — 519)
IX. Diseases of digestive organs
Diseases of an oral cavity, sialadens and jaws (520 — 529)
Diseases of a gullet, stomach and duodenum (530 — 537)
Appendicitis (540 — 543)
Hernia of an abdominal cavity (550 — 553) Noninfectious enteritis and colitis (555 — 558)
Other diseases of an urinary system (560 — 569)
Other diseases of digestive organs (570 — 579)
X. Diseases of urinogenital system
Nephrite, nephrotic syndrome and nephrosis (580 — 589)
Other diseases of system of urination (590 — 599)
Diseases of men's generative organs (600 — 608)
Diseases of a mammary gland (610 — 611) Inflammatory diseases of women's pelvic bodies (614 — 616)
Other diseases of female generative organs (617 — 629)
XI. Complications of pregnancy, childbirth and puerperal period
Pregnancy with an abortal outcome (630 —-639)
of the Complication,
the Normal childbirth and other indications for medical care at pregnancy, childbirth and delivery (650 — 659)
of the Complication arising preferential at the time of delivery and deliveries (660 — 669)
of the Complication of a puerperal period (670 — 676) connected preferential with pregnancy (640 — 648)
XII. Diseases of skin and hypodermic cellulose
Infections of skin and hypodermic cellulose (680 — 686)
Other inflammatory diseases of skin and hypodermic cellulose (690 — 698) Other diseases of skin and hypodermic cellulose (700 — 709)
XIII. Diseases of a musculoskeletal system and connecting fabric
Arthropathies and related disturbances (710 — 719)
Dorsopatiya (720 — 724) Revmatizm, except for rheumatism of a backbone (725 — 729)
Osteopathy, chondropathies and the acquired musculoskeletal deformations (730 — 739)
XIV. Congenital anomalies (malformations) (740 — 759)
XV. The separate states arising in the perinatal period (760 — 779)
XVI. Symptoms, signs it is also inexact the designated states
Symptoms (780 — 789)
the Nonspecific aberrations revealed during the researches (790 — 796)
It is inexact the designated and unknown causes of illness and death (797 — 799)
XVII. Injuries and poisonings
Fractures of bones of a skull (800 — 804) Spinal fractures and bones of a trunk (805 — 809)
Fractures of bones of an upper extremity (810 — 819)
Fractures of bones of the lower extremity (820 — 829)
Dislocations (830 — 839)
of Stretching and deformation of joints and adjacent muscles (840 — 848) Intracranial injuries, except for injuries with a fracture of a skull (850 — 854)
of the Injury of internals of a chest cavity, abdominal cavity and a basin (860 — 869)
Open wounds of the head, neck and trunk (870 — 879)
Open wounds of an upper extremity (880 — 887)
Open wounds of the lower extremity (890 — 897)
of Damage of blood vessels (900 —-904)
the Remote effects of injuries, poisonings, influences of toxics and other external reasons (905 — 909) Superficial injuries (910 — 919)
Bruises without damage of integuments (920 — 924)
of Crush (925 — 929)
of the Effect of penetration of foreign bodys through natural foramens of an organism (930 — 939)
Burns (940 — 949)
of the Injury of nerves and a spinal cord (950 — 957)
Separate complications of injuries and neutoch-nenny injuries (958 — 959)
of Poisoning with pharmaceuticals and biological substances (960 — 979)
Toxic effect of substances, preferential not medical prescription (980 — 989)
Another and not specified influences of the external reasons (990 — 995)
of the Complication caused by surgical and therapeutic intervention which are not classified in other
headings (996 — 999) Interpretation of Three-digit Headings it is shown on the example of the XII class.
XII. Diseases of skin and hypodermic cellulose
Infections of skin and hypodermic
cellulose (680 — 686) 680 the Anthrax and a furuncle
of 681 Phlegmon and abscess of fingers of a brush and foot
682 Other phlegmons and abscesses
683 Acute lymphadenitis
of 685 Pilonidalnaya a cyst
686 Other local infections of skin and hypodermic cellulose
Other inflammatory diseases of skin and hypodermic
cellulose (690 — 698) 690 the Erythematic and squamous dermatosis
691 Atopic dermatitis and related states
692 Contact dermatitis and other forms of eczema
693 Dermatitis caused by substances accepted inside
694 Violent dermatosis
695 Erythematic states
696 Psoriases and psoriazopodobny diseases
698 Itch and related states
Other diseases of skin and hypodermic
cellulose (700 — 709) 700 of the Callosity and callosity
701 Other hypertrophic and atrophic conditions of skin
702 Other dermatosis
703 Diseases of nails
704 Diseases of hair and hair follicles
705 Diseases of sweat glands
706 Diseases of sebaceous glands
707 Chronic ulcer of skin
708 Small tortoiseshell
709 Other diseases of skin and hypodermic cellulose
Additional classification of the external reasons of injuries and poisonings includes 23 groups and contains 192 headings. «Accidents on railway transport» are presented to classifications, e.g., (E800 — E807); «Road motor-trans-tailors accidents» (E810 — E819); «Not road motor-transport-nye accidents» (E820 — E825); «The accidents connected with other road vehicles» (E826 — E829), etc.
In separate group pharmaceuticals and biol, substances as the reason of adverse reactions at their therapeutic use» are allocated «(E930 — E949); «Suicides and self-damages» (E950 — E959); «The murders and damages which are purposely put with other persons» (E960 — E 969), etc.
This classification, and also additional classification of the factors influencing the state of health and the appeal of the population to healthcare institutions in the greatest measure is exposed to adaptation in various countries according to national peculiarities of health care of the country.
Additional classification of the factors influencing the state of health and appeals of the population to healthcare institutions includes 8 groups and contains 82 headings. In it groups of the states though which are not relating to diseases and injuries, but being the reason of the address in to lay down are presented. - professional, institutions: mass routine medical examinations of healthy faces, hospitalization concerning preparation for prosthetics, stay of healthy newborns in the relevant chambers of maternity hospitals, the advisory help — about methods of contraception, etc.
Classification of the ninth review, as well as three previous, is generally methodical grant for statistics of incidence and causes of death. Therefore in it the methodical partitions providing unity in preparation of primary documents of statistical property, existing even from the sixth review into Krom figure prominently the agreement on unification of terminology and a method of selection of one cause of death for statistical development was for the first time reached. The reason which is subject to selection was called an initial cause of death and was defined as: a) the disease or an injury which caused development of the disease processes which directly led to death, or b) circumstances of accident, to-rye caused a fatal injury. Along with it the medical certificate about a cause of death and rules of classification, a uniform order of record of all diseases and patol was approved, states, to-rye led to death or promoted its approach. The order of record of causes of death provided in the international form of the certificate, and use of the rules of selection attached to classification provide uniformity in definition of an initial cause of death, i.e. correctness of selection from a complex of the interacting diseases of that initial pathological process, to-ry then led to death.
Rules of codification and a priority at selection of an initial cause of death from combinations of the interconnected diseases are defined.
The rule of selection of a basic disease for one-causal development of materials about incidence of preferential hospitalized patients is for the first time developed. According to this rule that is selected «a ground state concerning which treatment or examination during the corresponding period of hospital or other type of medical care is conducted. If the diagnosis is not made, the main symptom or other disease state which was the cause of the request for medical care is selected». Selection of a basic disease (state) shall be made by the attending physician. At the same time it is recommended to carry out an encryption and the analysis of the multiple reasons, i.e. all diseases and states specified in medical documentation.
The system of the additional international classifications providing unity in developments of materials about incidence taking into account primary activities of medical institutions is included. These are classifications of surgical interventions and procedures, methods and procedures of diagnostic character, X-ray radiological medical and diagnostic work, etc. The international conference on the ninth review of MKB recommended these classifications at the first stage for carrying out experimental works with the subsequent their adaptation for the certain countries.
Classification of surgical procedures consists of 99 headings, each of to-rykh includes from 3 to 10 subheadings. E.g., the heading 5 — 47 of «Operation on a worm-shaped shoot» is presented by the following subheadings:
5 — 470 Appendectomy
it is included: appendectomy about a drenazhy
5 — 471 Drainage of appendicular abscess
5 — 479 Other operations on a worm-shaped shoot the Appendicostomy. Closing of fistula of Operation at cross development can be distributed on headings of classification of diseases and the reasons of hospitalization.
Classification of laboratory procedures consists of 88 headings, each of to-rykh includes 6 — 10 subheadings. The name of a subheading usually matches the name a lab. test. Its appointment in the standardization accepted in a wedge, laboratories of terminology and in use for developments, joint with studying of incidence. This classification is in process of implementation.
As the annex to MKB also classifications of drugs, medicines and biologically active agents, classification of permanent disturbances of health, loss of ability to any type of activity and disfigurations are prepared. This classification provides statistics of the medical and social help for planning of medical, professional and social rehabilitation of various groups of the patients or persons who are in a stage of rehabilitation.
For statistical development of materials out-patient poliklini-cheskoy to the help to the population the essential advantage is rendered by the classification of not medical types of activity finished in MKB of the ninth review; it is used when actually classification of diseases is inapplicable, active process of a disease and its treatment ended.
In 1978 the management of WHO began preparatory work for the tenth review of MKB, to-ry is oriented to wide use of the COMPUTER and studying of interrelations between separate diseases and causes of death of various groups of the population. This work is carried out with direct participation of 6 regional centers of WHO for classification of the diseases which are consistently created for adaptation of MKB in the corresponding languages in Washington, Caracas, London, Moscow, Paris, San Paulo.
The nomenclature and classification of diseases in military medicine
The nomenclature and classification of diseases in military medicine it is used for the purpose of standardization of primary medical accounting of the struck and sick military personnel, and also ensuring uniform understanding of the registration units applied in military-medical statistics for the subsequent pooling of data and the analysis of the materials characterizing a dignity. losses of troops (see. Sanitary losses ), health of the military personnel, the movement and the result of treatment struck and patients in divisions, parts and institutions of medical service. The etiopatogenetichesky and organosistemny principles are put in a basis of military-medical classifications of defeats and diseases. Reflecting sovr. level of medical and military-medical science, classification and the nomenclature, establish terminology, uniform, obligatory for all doctors, for designation of the defeats and diseases which are found among the military personnel, provide uniform reference of nosological forms to these or those groups and classes of defeats (diseases).
Work of first-aid posts also to lay down. institutions of army and the fleet, the result of treatment struck and patients cannot be characterized and estimated without detailed consideration of structure of the defeats and diseases treated in forms, groups and classes.
The classification and the nomenclature of fighting defeats accepted on wartime includes evidence-based group of all types of a fighting injury, can be caused edges sovr, weapons of destruction: mechanical, thermal, radiation, toxic agents, biol, weapon, etc. All fighting defeats are subdivided according to the accepted classification into 6 main classes, each of to-rykh includes separate groups, and each group — these or those nosological forms. So, the I class «Bruises» included 8 groups (injury of the head, a neck, a breast, a stomach, a basin, a backbone, upper extremities, lower extremities); in the II class «Thermal Defeats» — burns and freezing injuries; in the III class «Radiation Defeats» — acute and hron, radiation defeats; in the IV class «Gas poisonings» — defeats of OV neuroparalytic, all-poisonous, dermatovesical, suffocating, other OV (including isikhotomimetichesky, irritating, tear, etc.); in the V class «Defeats by a Biological Weapons» — the diseases which resulted from use of bacteria, viruses, rickettsiae, fungi, toxins; in the VI class «The Reactive States Arising in Wartime» — short-term and long forms of reactive states.
Military-medical classification and the nomenclature of diseases, injuries and causes of death on peace time corresponds to original positions of the International classification of diseases, includes 15 classes of diseases, 120 headings (nosological forms) and is constructed by the etiological and anatomo-physiological principle. Due to a number of specific features of age and sex list of the military personnel of army and fleet, and also with features of conditions of military work, life and life of staff, the nomenclature of diseases included only those diseases (and their classes), the probability of emergence to-rykh among the military personnel of the private and officers is most real.
In cases if at the wounded or the patient who addressed for medical aid, not one is diagnosed, and several diseases (wounds), establish the diagnosis of the main wound or disease, to-ry and reflect in documents of the medical reporting (see. Reporting medical, military-medical reporting ).
It is necessary to be guided by the following rules at the choice of the diagnosis of the main wound (disease) and a cause of death in the sequence provided in this scheme: the basic should be considered primary (in the etiological and chronological relation) wound, a disease, but not its complication; preference is given to the diagnosis of more severe or mortal wound (disease); in the presence of acute and hron, diseases (defeat) of the basic the diagnosis of an acute disease (defeat) is considered; the diagnosis epid, diseases (defeats by microbic forms of bacteriological weapon) is given preference before diagnoses of other diseases, wounds; at two wounds (diseases) identical on weight, the basic should be considered that, a cut affects fighting capacity and working ability of wounded (patient) more hard or demands more difficult and prolonged treatment.
During the use of the provided scheme of the choice of the diagnosis of the main wound (disease) each its rule becomes effective in that case when previous cannot be applied.
Bibliography: Kamensk L. S. Medical and demographic statistics, page 265, M., 1974; New rural S. A. Demografiya and statistics, page 193, M., 1978; Nomenclature of diseases, M., 1953; V. K. K Sheepherds to introduction in the USSR the International statistical classification of diseases, injuries and causes of death, Owls. zdravookhr., No. 6, page 36, 1964; The Grant according to the nomenclature of diseases and maintaining the medical accounting of the sick military personnel in Armed Forces of the USSR (on peace time), M., 1971; Guide to the international statistical classification of diseases, injuries and causes of death, t. 1 — 2, M., 1968; Guide to the international statistical classification of diseases, injuries and causes of death, t. 1, Geneva, WHO, 1980; Encyclopaedic dictionary of military medicine, t. 3, Art. 1359, M., 1948; Manual of the international statistical classification of diseases, injuries and causes of death, Geneva, 1977.
V. A. Bystrova, V. K. Ovcharov; L. E. Poles (soldier.).