From Big Medical Encyclopedia

FTIZIATRYYa (Greek phthisis death, tuberculosis + iatreia treatment; a synonym a ftiziologiya) — the section of clinical medicine devoted to studying of an etiology, pathogeny, epidemiology of tuberculosis, development of methods of its diagnosis, treatment and prevention, and also the organization of delivery of health care by the TB patient.

Formation of phthisiology took place a multi-stage way of development and was result of scientific achievements in the field of studying of tuberculosis, and also medicine in general (see Medicine). The crucial role was played by opening of the causative agent of tuberculosis by R. Koch (see Tuberculosis, history).

Originally F. formed as the doctrine about tuberculosis disclosing ways and sources of infection with mycobacteria of tuberculosis (see Mycobacteria), development of infectious process as a result of interaction of a disease-producing factor and a macroorganism taking into account a condition of immunity and pathomorphologic changes. Most studying of biological properties of the causative agent of tuberculosis and

improvement of methods of detection of mycobacteria with the help * microscopic and bacterial was important. methods. It found reflection in I. I. Mechnikov's works, N. F. Gamalei, and in the subsequent V. I. Kedrov-sky, JI. A. Tarasevich, M. M. Tsekh-novitser, Yu. K. Veysfeyler,

A. I. Kagramanova, R. O. Drabki-na. A. Kalmett and Geren's researches had special value (S. of Guerin), the Crimea managed to be received, the avirulent strain of mycobacteria of a bull look which received nazvaniye-BTsZh (see). The vaccine which is produced from this strain since 1921 is used for preventive tuberculosis inoculations.

Development of the clinical direction F. it is connected with names of founders of domestic medicine of the 19th century of M. Ya. Mudrov, G. I. Sokolsky, G. A. Zakharyin, S. P. Botkin, A. A. Ostroumov. In the twenties Soviet phthisiatricians-clinical physicians

of B. A. Vorobyov, A. Ya. Shternberg,

V. JI. Einys, V. A. Chukanov, F. G. Yanovsky described a wedge, displays of a pulmonary tuberculosis at adults, A. A. Kisel, I. V. Tsymbler. M. P. Pokhitonova — at children. The works published by G. R. Rubenstein were devoted to early and initial forms of tuberculosis. B. M. Khmelnytsky, V. A. Ravich-Shcherbo, I. E. Kochnova. The big contribution to the doctrine about primary tuberculosis was made B. M. Khmelnytsky.,

A. E. Rabukhin, etc.

Abroad problems of tuberculosis were developed by R. Laennek K. Rokitansky, R. Virkhov, J. A. Villemin, JI. Ashof-f, A. Ghon, etc.

Domestic scientists considered tuberculosis as the general infectious disease from positions of unity local and the general in pathology. Interrelation patomorfo l. changes in the struck bodies and the general disturbances it was opened in A. I. Abrikosov's researches, and then in works V. G. Shtefko, A. I. Stru-kov, V. I. Puzik, etc. Disturbances of regulation of function of various bodies at tuberculosis were described by A. D. Speransky, A. D. Semenov, JI. M. Model, etc.

Development of the doctrine about a pathogeny and clinic of tuberculosis led to development of various methods of its diagnosis directed first of all to active early identification of patients. In early diagnosis of tuberculosis the important role was played by A. E. Prozorov's researches,

K. V. Pomeltsova who described rentgenol. picture of various forms of a pulmonary tuberculosis. Studying of a picture of blood at tuberculosis H allowed N. A. Shmelyov. To establish to N. Bobrov additional criteria of activity and weight of tubercular process. Use of a tuberculinodiagnosis (see) in combination with laboratory researches, including immunological, was allowed to judge more precisely activity of tubercular process at absence rentgenol. signs of activity. N. A. Shmelyov and E. D. Timasheva made a big contribution to development of methods of an aspiration biopsy and tsitol. diagnoses of tuberculosis. The endoscopic methods of a research (see Endoscopy) developed by A. Ya. Qi-gelnik, A. N. Voznesensky in combination with tsitol. allowed to resolve by a research nek-ry difficult issues of differential diagnosis of tuberculosis (see Tuberculosis, Tuberculosis of a respiratory organs).

Long time major importance in treatment of suffering from tuberculosis lungs methods of a collapsotherapy (see), in particular had the medical pheumothorax (see Pheumothorax artificial) offered in 1882 Mr. of Forlanini (S. of Forlanini), and in the subsequent the developed

A. N. Rubel, A. Ya. Shternberg,

B. A. Ravich-Shcherbo, F. A. Mikhaylov. With the advent of antitubercular drugs (see. Antituberculous remedies) the role of methods of a collapsotherapy sharply decreased, the leading place was taken by chemotherapy (see), edge allows to try to obtain treatment of patients not only with initial displays of tuberculosis, but also with severe common forms. The big contribution to development of methods of chemotherapy was made by N. A. Shmelyov, A. E. Rabukhin, etc. Abroad questions of chemotherapy of tuberculosis are taken up in W.Fox, J. Bignall, J. Crofton's works, etc.

In development of operational methods of treatment of suffering from tuberculosis lungs the big contribution was made by K. D. Yesipov, N. G. Stoyko, JI. K. Bogush,

N. V. Antelava, A. G. Kiselyov, I. S. Kolesnikov, etc. In studying of questions of a pathogeny, clinic and treatment of a tuberculosis of bones and joints (see Tuberculosis extra pulmonary) T. P's works had importance. Red bayeva, P. G. Korneva and 3. Yu. Rolye. The principles of the sanatorium therapy including methods of rehabilitation of TB patients were developed by F. G. Yanovsky, H. N. Green-charom, S. V. Kurashov, A. I. Lapina, etc. Researches of the last years in the field of epidemiology of tuberculosis, carrying out mass inspections of the population of various regions of the country allowed to improve organizational forms of antitubercular actions.

Specialization F. by the organ principle in connection with development of diagnostic methods and treatments, allocation of extra pulmonary localizations of tuberculosis (e.g., tuberculosis of eyes, skin, c. N of page, etc.), demanded involvement of doctors of other specialties (ophthalmologists, gynecologists, dermatologists, neuropathologists, urologists, etc.). At the same time similarity kliniko-rentgenol. demanded displays of tuberculosis and nonspecific diseases of lungs from phthisiatricians of knowledge not only in the field of phthisiology, but also pulmonology (see) that causes gradual rapprochement of these sections a wedge, medicine.


Current state F. it is characterized by the intensive scientific research conducted in our country in the following directions: 1) epidemiology and about

a filaktik of tuberculosis, improvement of organizational forms of the ftiziatrichesky help to the population; 2) microbiology of tuberculosis, development bacterial. methods of a research; 3) immunology, genetics and immunomorphology of tuberculosis;

4) diagnosis, clinic and differential diagnosis of tuberculosis and other pulmonary diseases;

5) pathophysiology of breath and blood circulation, biochemical bases of a pathogeny of tuberculosis; 6) etiopa-togenetichesky and operational methods of treatment.

Planning of scientific research is carried out by the problem commission of allied value on tuberculosis entering into Scientific council on problems of phthisiology and pulmonology at Presidium of the USSR Academy of Medical Sciences. Head research establishment on tuberculosis is the Central scientific research institute of tuberculosis the M3 of the USSR created in 1921 to-ry together with republican scientific research institutes of tuberculosis carries out research on phthisiology and performs organizational and methodical management of antitubercular work in the country. The largest institutions of this profile abroad are: Ying t of tuberculosis and pulmonology of Co-ranyi (VNR), Research in-t of pulmonary diseases and tuberculosis (GDR), Research in-t of tuberculosis and respiratory diseases (ChSSR), the Center for a pneumology and phthisiology (NRB), Ying t of a ftiziologiya (SRR), the Center of tuberculosis and diseases of lungs of Council of a scientific medical research at Bromptomsky hospital (Great Britain), Ying t of Forlanini (Italy), etc.

Training of students on F. specialization and professional development of doctors — in a clinical internship and a postgraduate study of a pas departments and in scientific research institute of tuberculosis, and also at departments of tuberculosis of in-t of improvement of doctors is carried out at departments of tuberculosis of medical in-t, and.

For achievements in the area F. Lenin awards to L. K. Bogush (1961), P. G. Korneva (1965), A were awarded. To E. Rabukhin (1980). The state awards of the USSR noted works T. B. Krasno-bayeva (1949), G. R. Rubenstein (1951), P. G. Korneva (1952), L. K. Bogusha (1974), A. E. Rabukhina

(1976), A. G. Homenko (1982), etc.

Since 1948 in the country functions All-Union scientific medical

about-in phthisiatricians, combining all republican science medical foundations of phthisiatricians. 9 All-Union congresses of phthisiatricians are held (the first took place in 1922). Since 1956. All-Union scientific medical about-in phthisiatricians enters into the non-governmental international organization — the International antitubercular union combining national scientific about-va phthisiatricians and ftiziopu-lmonolog of 114 countries. The international antitubercular union regularly holds the international conferences, in 1982 the XXV international conference in Argentina took place. The Soviet scientists-phthisiatricians participate in work of Executive committee, scientific committees, the international conferences held by the International antitubercular union and also are WHO experts. National science foundations or associations of phthisiatricians and ftiziopulmonolog are available in many countries. The largest are science foundations in France, England, Germany, Italy, GDR, Hungary, Yugoslavia, Japan, the USA, Canada, Argentina, etc.

In the USSR questions F. are covered in the Problems of Tuberculosis magazine appearing since 1923 and also in other medical magazines (e.g., «The Soviet medicine», «Chest surgery», «Clinical medicine», in all republican magazines concerning health care, etc.), the guides, monographs and textbooks. In the Central scientific research institute of tuberculosis M3 of the USSR collections of works on questions F are systematically published. The materials published in foreign magazines and editions are covered in «The medical abstract magazine» (the section II «Tuberculosis and pulmonology»), and also in reviews on pages of medical magazines.

The short list of periodicals on F. — see the bibliography. Bibliography: History — Bogush JI. To. Development of surgery of a pulmonary tuberculosis in the Soviet Union in 60 years, Probl. tube., No. 11, page 13, 1977; To and and N about in and the p P. B. From history of fight against tuberculosis in dore-

volyutsionny Russia, M., 1952, bibliogr.; Rabukhin A. E. The historical sketch of development of the doctrine about tuberculosis, is A lot of * tomn. the management on a tube., under the editorship of

V. - L. Einys, t. 1, page 9, M., 1959;

To e e r s R. Y. Pulmonary tuberculosis, A journey down the centuries, L., 1978.

Textbooks, the guides, the reference media — Alexandrov A. V. Radiological diagnosis of tuberculosis of a respiratory organs, M., 1983; In au g at sh L. K. Kavernotomiya at suffering from tuberculosis lungs, M., 1955; B about -

at sh L. K., Travin A. A. and With e-menenkov Yu. L. Operations on primary bronchi through a cavity of a pericardium, M., 1972; Immunology and an immunopathology of tuberculosis, under the editorship of M. M. Averbakh, M., 1976; Cavernotomy and other methods of topical treatment legochnokhyu tuberculosis, under the editorship of N. Chuzo, the lane with English, M., 1972; To and - with e l A. A. Tuberkulez at children, century

1 — 3, M., 1941 — 1949; Kornev P. G. Surgery of bone and joint tuberculosis,

4. 1 — 3, L., 1971; A. I.

Organization's Wingnut of fight against tuberculosis in the USSR, M., 1969; Markuzon V. D. Tuberculosis at children and teenagers, M., 1958; M e in e E. B. Tuberkulez at persons of young age, Kiev, 1964; The Multivolume guide to tuberculosis, under the editorship of

V. L. Einys, t. 1 — 4, M., 1959 — 1962;

H e z l and S. E's N., of p e y m of e p M. C. and Protopopov of H. M. Antitubercular clinic, M., 1979; To Poma of l c about in K. V. Radiological diagnosis of a pulmonary tuberculosis, M., 1971;

II about x and M. P's tonova. Clinic, treatment and prevention of tuberculosis at children, M., 1965; Prozorov A. E. Radiodiagnosis of a pulmonary tuberculosis, M. — L., 1940; Puzik V. N., Uvarova O. A. and Averbakh M. M. Patomorfologiya of modern forms of pulmonary tuberculosis, M., 1973; R and at x both A. E. Epidemiologiya's N and prevention of tuberculosis, M., 1957; it, Chemotherapy of TB patients, M., 1970; it, Tuberculosis of a respiratory organs at adults, M., 1976; it, Chosen works, M., 1983; Ravich-Shcherbo V. A. A pulmonary tuberculosis at adults, M., 1953; Radanov R. Tuberculosis at children and teenagers, the lane with bolg., Sofia, 1967; P e y N in and l d A. A. The pulmonary tuberculosis is aged more senior than 50 years, L., 1973; Repin Yu. M. Fundamentals of surgical phthisiology, L., 1976; Rubin

G. R's matte. Pulmonary tuberculosis, M., 1948; The Guide to tuberculosis of a respiratory organs, under the editorship of S. M. Knyazhetsky, L., 1972; The Reference book of the phthisiatrician, under the editorship of N. A. Shmelyov and V. L. Einys, M., 1975; N. G Is firm. Surgical treatment of pulmonary tuberculosis, M., 1949;

With t r at to about in A. I. Forms of pulmonary tuberculosis in morphological lighting, M., 1948; With t r at to about in A. I. and Solovyov I. P. Morphology of tuberculosis in modern conditions, M., 1976; The Theory and practice of the Soviet phthisiology, under the editorship of F. V. Shebanov, M., 1969; Toman K. Tuberculosis, identification and chemotherapy, the lane with English, M., 1980; Tuberculosis, under the editorship of 3. A. Lebedeva and N. A. Shmelyov, M., 1955; Tuberculosis of bodies of breath:!, under the editorship of A. G. Homenko, M., 1981; sg and r with about in and V. A. Tuberkulez of a respiratory organs at children, M., 1978;

X and r and N of and L. and With c e m e N and K.

Patologiya of tuberculosis at advanced age, the lane with English, M., 1978; Chemotherapy of a pulmonary tuberculosis, under the editorship of A. G. Huo

menko, M., 1980; Surgical treatment of a pulmonary tuberculosis, under the editorship of L. K. Bogush, M., 1979; Homenko A. G.

Clinic and treatment of cavernous forms of a pulmonary tuberculosis, Kiev, 1964; it, Theory and practice of fight against tuberculosis as problem of the international health care, M., 1975; Shebanov F. V. Tuberculosis, M., 1981; Einys V. L. Bases of treatment of the patient with pulmonary tuberculosis, M., 1956; Yablokov D. D. and Galibina A. I. A pulmonary tuberculosis in combination with internal diseases, Tomsk, 1976; I shch e and to about B. P. Topical issues of tuberculosis of a respiratory organs, Kiev, 1980; Sjvremenni of a vjprosa on a tuber-kulozat, under the editorship of St. Todorova and R. Rada-is new, Sofia, 1970; In 1 a h and N. of Die Lun-gentuberkulose im Rontgenbild, B. u. a., 1976, Bibliogr.; Fortschritte der Tuberku-lose-Forschung und-Behandlung, hrsg. v. H. Birkhauser, Basel — N. Y., 1968; Hand-buch der inneren Medizin, hrsg. v. H. Schwiegk, Bd 4, T. 3, B. u. a., 1981; Immunological aspects of leprosy, tuberculosis and leishmaniasis, ed. by D. P. Humber, Amsterdam a. o., 1981; The radiology of tuberculosis, ed. by B. Felson, N. Y. a. o., 1979; Rifampicin and current policies in antituberculosis chemotherapy, ed. by D. M. Burley, L., 1973.

Periodicals — the Medical abstract magazine, the Section 2nd, Tuberculosis and pulmonology, M., since 1957; The Pneumology and phthisiology, Sofia, since 1975; Problems of tuberculosis, M., since 1923; Radiology diagnosis, the International magazine on radiodiagnosis, Berlin, since 1960; American Review of Respiratory Diseases, N. Y., since 1960 (1917 — 1955 —

American Review of Tuberculosis, 1955 — 1959 — American Review of Tuberculosis and Pulmonary Diseases); British Journal of Diseases of the Chest, L., since 1959 (

1907 — 1943 — British Journal of Tuberculosis,

1944 — 1958 —

British Journal of Tuberculo sis and Diseases of the Chest); Chest, Chicago, since 1970 (1935 — 1969 —

Diseases of the Chest); Ftiziologia, Bucure§ti, since 1952; Journal of Clinical Microbiology, Washington, since 1975; Kekkaku, Tokyo, since 1923; Lung,

V., since 1976 (1903 — 1964 —

Beitrage zur Klinik der Tuberkulose und spezifischen Tuberkulose-Forschung, 1965 — 1969 — Beitrage zur Klinik der Tuberkulose und der Lungenkrankheiten, 1970 — 1975 — Pneumo-nologie); Pneumologicka a ftiseologicka spolecnost, Praha, 1973; Pneumonologia Polska, Warszawa, since 1926; Studia Pneumolo-gica et Phtiseologica Gechoslovaca, Praha, since 1970; Therapiewoche, Karlsruhe, since 1950; Thorax, L., since 1946; Tubercle, Harlow, since 1919. See also bibliogr. to St. Tuberculosis, Tuberculosis extra pulmonary, Tuberculosis of a respiratory organs. A. G. Homenko.