To the methodology of clinical disciplines

In the second issue of the Kazan Medical Journal for this year, Prof. A. A. Kisel published an article entitled "To the doctrine of the absolute symptom complex"; this article is a further development of the thoughts expressed by Prof. Kissel in 1929 in the message "To the doctrine of the absolute symptom" (Medical case, No. 21). In this, the first in time, article, the author, having listed several symptoms characteristic of certain diseases (small nodules on the tendons in rheumatism, the course of temperature in malaria and Gochkin's diseases, cough in whooping cough, ulcer on the cheek in nome, etc.) proposed to call such symptoms "absolute". Pointing out that the clinic of many diseases has not been studied enough, he urged doctors to develop it and identify "absolute symptoms" for other diseases as well. The second article presents the symptomatic complexes typical for one or another disease: for croup pneumonia, for the onset of acute articular rheumatism, for the disease 8I1YA, dysentery, malaria, whooping cough and asthma. Considering that "the best way to treat diseases is to set baseline standards for all kinds of diseases", and that "only those diseases that have an absolute symptom complex can be identified", the author recommends that doctors study such "absolute symptom complexes" at the patient's bedside. "We can't wait," he says, "until the laboratory finds a way to distinguish some diseases from others." In both articles there are a number of indications that the laboratory, and especially bacteriology, did not justify the hopes placed on them. "It's time to put a limit to the hobby of the laboratory bias," says the first conclusion of the first article. It is necessary to "beat the lights out" in relation to the fascination of clinicians with bacteriology-it is said in the second article. In this regard, the author recalls that Prof. B ve se r, the predecessor of S. P. Botkin's department at the Military Medical Academy, considered it possible to recognize diseases by smell, for example, smallpox during suppuration-by the smell of a "sweating goose".