SOVIET CONFERENCE ON THE THERAPY OF TERMINAL CONDITIONS

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP80-00809A000700180280-0
• Release Decision: RIPPUB
• Original Classification: U
• Document Page Count: 6
• Document Creation Date: December 22, 2016
• Document Release Date: September 6, 2011
• Sequence Number: 280
• Publication Date: May 17, 1954
• Content Type: REPORT

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SOVIET CONFERENCE ON THE THERAPY OF TERMINAL CONDITIONS
Vestnik Akademii Meditsinskikh Nauk SSSR L. G. Shikunova, A. M. Gurvich, Lab oi'
No , pp 53-55 Experimental P
Moscow, Dec 1953 I~Ysiol on the Resuscitation
of Organisms, Acad Med Sci USSR
Work on the problem of the therapy of terminal conditions, which is based on
the understanding of death from the standpoint of dialectical materialism, has
enabled Soviet science to occupy the leading position in the world in research in
this field.
The Academy of Medical Sciences USSR, together with the Administration of
City Hospitals of the Ministry of Public Health USSR, held a conference on prob-
lems o1' pathophysiology au~ the therapy of terminal conditions at the clinic and
in practical emergency aid. This conference took place in Moscow between
10 and 12 December 19>`2. The ournose of the conference was to summarize results
of the investigation of the puthophysiologyof terminal conditions, to exchange
experiences in this field, and to discuss results of the therapy of severe forms
of shack, extreme pain, and clinical death.
One o1' the tasxs of the conf'eren~e was the planning of measures for wider
Sntroduction into the practice of Soviet public health protection of the complex
method of restoring ill's functions which was developed at the Laboratory of Ex-
perimental Physiology on the Resuscitation of Organisms (laboratory head, Pro-
fessor V. A. Negovskiy).
The work of the conference presented a striking demonstration of the close
collaboration between experimental workers and clinicists. Pathophyaiologists
and physiologists active in work on the problem of restoration of life functions,
chief surgeons and obstetricians-gynecologists of the republics, surgeons at-
tached to major emergency medical-aid stations, surgeons of new construction
works, and practical physicians and scientific uorkera from Leningrad, Kiev,
Ashkhabad, Yerevan, Tallin, Alma_Ata, Ryazan', Tula, and from a number of other
cities In the Soviet Union took part in the conference. Visitors from scientific
research institutes and therapeutic institutions 1n Kazan', Tashkent, Odessa,
Frunze, and other cities were also present at the conference. The total at-
tendance at the conference was 598. AmonE those attending, 472 represented
therapeutic and scientific institutions in Moscow and 126 were from out of town.
The conference uas opened by S. Ye. Severin, Active Member, Academy of Medi-
cal Sciences USSR. At five sessions of the conference, 17 reports were heard.
Thirty-seven participants took part in the discussions. The results and prospec-
tive advances in research in the field of pathophysiology of terminal conditions
were presented in eight theoretical papers. Nine reports were devoted to results
of the application of methods for the restoration of vital functions at a number
of surgical clinics, obstetric-gynecoloEical clinics, and rayon hospitals.
The papers presented at the conference were marked by a high ideological
and theoretical level and contained new and valuable scientl2'ic de.ta.
In the theoretical part of the report given by Professor V. A. Negovskiy,
the role oz' the central nervous system, and particulnrly of the cerebrel cortex,
in the process of dying and the restoration of vital functions of the organism
was discussed. The principal stages of dying and resuscitation of the organism
were characterized by Negovskiy from the standpoint of Pavlov's nervism. On
the basis of experimental data, he clarified the role of neuroreflective mechan_
isms and of the central nervous system in the restoration of the activity of the
heart, respiration, and intermediate metabolism.
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Negovskiy stressed n^.rticularly the significance of the cerebral cortex
in the process of restoration of vital functions of the organism. He indicated
the role of he cerebral cortex in the restoration of the entirety of the organism
and of its unity with the environment, as well as in the compensation of the
functions of other divisions of the central nervous system which had been dis-
turbed during the process leading to death.
Problems subject to further experimental research in this field were
enumerated. The study of the tapering off and the restoration of higher nervous
activity, the sea^ch for conditions which prevent a rapid development of irrever-
sible changes in the central nervous system, and expansion and perfection of the
complex method of restoration of the vital functions of the organism belong to
these problems.
E. A. Asratyan, Corresponding Member, Acadergy of Sciences SSSR, reported
on the method oi' anemizatior, 01' the central nervous system and presented ex-
perimental data obtained by this method in connection with an investigation of
the stability of various sections oi' the brain to anemia. The work was carried
out with C. T. Sakhiulina. After pointing out the high sensitivity of the cere-
bral cortex to anemia, Asratyan indicated that there is the possibility of com-
pensation within a certain time of injuries that have occurred in the cortex as
a result of anemia. In conclusion, Asratyan emphasized some possibilities of
restoring the functions of the cerebral cortex after the onset of anemia by
methods which had not yet been utilized.
In a report replete with new experimental data, Professor V. S. Gallon
presented information on the role of vascular receptors in the organism's reac-
tions to the introduction of various substances into the blood stream. Gallon
showed that a number of substances and of liquids commonly used in medical
practice may produce diametrically different effects on blood circulation and
respiration, dependant only on the circumstance of whether they are introduced
into the venous or arterial part of the blood stream or the large or small blood-
circulation cycle.
On the basis of experiments conducted in the Laboratory he directed, Gal]cin
pointed out that the protective effect of some substances depends on the func-
tional condition of the nervous system at the time xhen introduction of the sub-
stance into the blood stream takes place. Ye. M. Smirenskaya, Candidate of
Medical Sciences, showed in her report that the most important role in the
restoration of cardiac activity after clinical death by the method of intra-
arterial blood transfusion under pressure must be ascribed to nerve reflectory
mechanisms. The r~~'lectory effects on the heart take place as a result of the
irritation of angioreceptors of the vascular wall.
In a report by Professor I. R. Petrov and Ye. V. Gubler, Candidate of Medi-
cal ?ciences, data were presented on methods of strengthening the protective in-
hibition which arises in the cerebral cortex during oxygen starvation of the
organism. The authors made an experimental evaluation of the effects on cortical
protective inhibitions of a number of anesthetics [literally, narcotics], of
hypothermia, and of mixtures of bromides with caffeine.
The regularities governing the restoration of cortical and subcortical func-
tions at the time when patients come out of a coma or related states were explained
in an extensive report made by Professor I. V. Strel'chuk.
L. V. Lebedeva presented experimental data on the basic relationships per-
taining to the extinction and restoration of cardiac activity and of respiration
in drowning.
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New data o^ changes in the intermediate metabolism of the cerebral cortex
??.uring the processes of dying and resuscitation of the organism were given in a
report presented by M. A. Gayevskaye, Candidate of Biological Sciences. She
demonstrated the close dependence of the carbohydrate metabolism of the brain
during extinction and restoration of vital functions of the organism on the func-
tional condition of the central nervous system.
In the clinical part of the report given by Professor Negovskiy, a^ analysis
of extensive clinical observations made by Soviet physicians in connection with
the therapy of terminal conditions was Riven. Negovskiy discussed in detail the
complex method of the restoration of vital functions and mode a number of prac-
tical indications which clarify the characteristic traits of the application of
this method at the clinic and in practical emergency aid. In conclusion, Negov-
skiy devoted some time to the most important aspects of further development of
the complex method and to the possibilities of eider introduction of this method
into practical use in the i'utui?e.
The informative report of professor p. E. Gulyayev was devoted to the most
important indications and contraindications for intro-arterial blood transfusion
in surgical practice, Gulyayev demonstrated that intro-arterial blood
transi'uslon plays the most important role in the .:yatem of restorative
measures to be applied in cases of decompensated, acute blood loss
(traumatic or surgical shock), 1. e., under conditions where blood trans-
:usion may have a negative effect.
A. N. Dakulev, Active Member, Academy of Medical Sciences USSR,
told of his experience in the application of intro-arterial blood trana-
fuslon at the surgical clinic. Bakulev stated that intro-arterial blood
transfusion is one of the most effective procedures for the treatment of terminal
conditions which have resulted from acute trauma, asphyxiation, caused by
anesthesia (literally, narcosis), and other causes. Intro-arterial blood
transfusion under p:?essurE is very simple and available to every
physician.
Results of the therapy of terminal conditions at the Surgical Clinic of
the Institute of Emergency Aid imeni Sklifosovskiy were presented in a report
made by the chief surgeon of this institute, Professor B. A. Petrov, and by
G. D. Chesnokova, Candidate of Medical Sciences.
In a re~ioi?t given by N. N. Priorov, Active Member, Academy of Medical
Sciences USSR, the principal problems of the pathology of trauma produced by an
electrical current were discussed.
N. L. Gurvich, Candidate of Medical Sciences, discussed in hie report his
theory concerning the origin of heax?t fibrillations, which represent the most
frequent [immediate] cause of death produced by trauma vhich is paused by an
electrical current. On the basis of his investigations, Ourvich has evolved a
method of stopping heart fibrillations by a condenser discharge without opening
up the chest. Of considerable interest was a paper by professor I. T. Mil'chenko
and N. P. Kalashnikova on the application of intro-arterial blood transfusion
under pressure in the obstetric-gynecological clinic. On the basis of experience
acquired at the obstetrical institutions of the city of Kuybyshev, the authors
of this paper stated that intro-arterial blood transfusion under pressure, in
combination with subsequent intravenous blood transfusion, produces a rapid
beneficial effect in the treatment of terminal conditions encountered in obste-
tric-gynecological practice.
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In a report made by L. 0. Ketler, physician at a :?ayon hospital in Kalinin
Oblast, it was pointed out that a very effective method for combating acute
shock. blood losses, or rapidly progressing intoxication of the organism is fur-
nished by the method of intro-arterial blood transfusion under pressure. The
simplicity of the equipment for intro-arterial transfusion under pressure and the
availability o'' this equipment under conditions existing at a rayon hospital~or
even at a district hospital, was especially emphasized in Ketler's report.
The effectiveness of the application of respirators of the pneumatic-cuff
type in cases of poliomyelitis accompanied by paralysis of the respiratory
musculature tas mentior:ed in a report given by Ye. V. Gotovtseva.
The work of the conference was conducted under conditions which encouraged
criticism and the free exchange of ideas. The great number of people who parti-
cipated iu the discussion of reports indicates this. Particularly lively was a
discussion of the duration of the period of clinical death during which complete
restoration of vital functions is still possible; on the mechanism of the restora-
tion of cardiac activity and, in connection with this, on the method of introduc-
ing blood into an artery; and on the necessity of producing equipment for artifi-
cial respiration in the shortest possible time. Both in the reports and in the
discussions, the effectiveness of the method of resuscitation developed at the
laboratory of Experimental Physiology on the Resuscitation of Organisms, Academy
of Medical Sciences USSR, was confirmed.
The work of the conference has shown that development of the problem of the
restoration of vital functions of the organism is carried out on the basis of
advanced Michurin bioloq~ and also from the standpoint of Pavlov's nervism.
It follows from the data presented at the conference that the problem of
the restoration of vital functions is being investigated in close correlation
with practical medical work. Up to the time when the conference xas held, in-
tro-arterial transfusion of blood had been carried out at USSR medical institu-
tions on 1,(14 patients who were in a state of acute shock, agony, or clinical
death. As a result of the application of intro-arterial blood transfusion, 797
patients were saved.
Additional information on the successful application of intro-arteries blood
transfusion in the cases of o2 patients was presented at the conference.
An instruction which had been confirmed by the Deputy Minister of Public
Realth USSR was communicated to the participants at the conference. This instruc-
tion dealt with introducing, into therapeutic practice, the method of restoring
vital functions which has been developed at the laboratory of Experimental Phy-
sloloEy for the Resuscitatio^ of Organisms, Acaderqy of Medical Sciences USSR.
Duritrg the discussion of reports, some shortcomings in connection xith the
development of work on this problem and tl:e introduction of the results of this
work into practical medicine were brought out. Some of these shortcomings are
the inadequate scope of investipatiors on the dynamics of the restoration and
extinction of nerve activity, the fact tlrat some institutions do not work on prob-
lems of resuscitation (for instance, the laboratory directed by S. S. BrYukhonenko),
lack of a sufficient theoretical basis for work on problems pertaining to the
resuscitation of organisms, and inadequate attention paid by the Ministry of Pub-
lic Health USSR, the Academy of Medical Sciences USSR, and the Laboratory of Ex-
perimental Physiology for the Resuscitation of Organisms, Academy of Medical
Sciences USSR, to the problem of mass production, in the shortest possible time,
of equipment for artificial respiration to be used at medical institutions.
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The resolution passed by the conference stated that it is necessary to
expand intensive theoretical work on the problem of the restoration of vital
functions of the organism on the basis of Pavlovian physiology and that it is
furthermore necessary to achieve extensive introduction of the methods that
have been developed in this field into the practice of Soviet public-health
protection, in close collaboration with clinicists.
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