Libmonster is the largest world open library, repository of author's heritage and archive

Register & start to create your original collection of articles, books, research, biographies, photographs, files. It's convenient and free. Click here to register as an author. Share with the world your works!

Libmonster ID: COM-920
Author(s) of the publication: Gennady POROSHENKO

share the publication with friends & colleagues

by Gennady POROSHENKO, Dr. Sc. (Biol.), Institute of Reanimatology, Russian Academy of Medical Sciences

Recently a young ambitious woman consulted at the Institute of Pulmonology, I. M. Sechenov Moscow Medical Academy, asked the doctor with horror: "Can I really have tuberculosis? Why, it is the disease of degenerated people!" "Not at all", she heard in response, "La Traviata and Anton Chekhov suffered from consumption, too" - "Are tuberculosis and consumption one and the same thing then?!" the patient wondered and, it seemed, even felt a little proud.

стр. 102

Back in the 19th century this severe disease became a global problem, all the more so that there was no proper treatment of it. ТВ did not spare people of any rank (even the Russian tsar's family), but was predominantly the lot of the poor, and was often considered a social malaise of the "rank and file" of society. Its name was consumption: the infected people were slowly, but inevitably consumed by the disease.

Advanced countries, in their attempts to check the progress of the disease and help its victims, organized a Tuberculosis Control League. Many of its active members appeared in Russia, and they had the widest strata of the population face the problem. At first the movement was restricted to private donations (from the tsarist family and aristocracy) and social charity, with three-thirds of donations being allotted to the creation and support of ТВ sanatoria (later they were organized by the zemstvos-elected organs of local self-administration). These institutions worked up ТВ cases. Simultaneously, specialized outpatient health centers were opened; this practice was copied from France. Also, one took care of weak patients (mainly children) from poor families and of relatives of patients, who were in permanent contact with them. By 1911 there had been more than 100 organizations running rest camps (colonies) in which more than 15,000 boys and girls improved their health in summer.

At the end of the 19th century societies for control of this, heretofore incurable, disease appeared in our country; small and scattered along its huge territory, they were known only to the few. In 1903 came an idea to unite these societies, but the turbulent events of the 1905 revolution delayed this intention, and the All-Russian Tuberculosis Control League appeared only 4 years later. There were not enough means for its activities, and, following the example of the Scandinavian countries, White Daisy Days were established: on those days in the most crowded city places and streets active members sold white flowers, natural or hand-made, bringing every kopeck into a common fund for the organization and maintenance of specialized medical institutions.

On April 20, 1911, the first action of this kind was held in Moscow, St. Petersburg, Kiev, Revel (now Tallinn, Estonia), Kronstadt, Nikolaev, Saratov, Simferopol, Tula, Ufa, and Yalta, then in about 100 more towns. The sum collected only in Moscow amounted to 67,214 roubles 7 kopecks. This precise sum means that it was always known, how much and where the money was donated and how it was spent. In order to give the modern reader a proper idea of this sum, let us note that in those years it was possible to buy a ship for 15,000 roubles.

Such broad campaigns involved many prominent persons. For example, on one of these days daisies in Yalta were sold by children of the Tsar, Nicholas II (HM family was on vacation there). The Tsar and his family donated large sums. The population at large also made their contributions, everyone-from businessmen to paupers. For example, the Lyutov family of merchants donated 200,000 roubles to their native town Vyazma (Smolensk province) on condition that one-quarter of this sum be spent for setting up a hospital for ТВ patients and the rest, for the construction of a water pipe; the profit gained from its exploitation was to be spent for the maintenance of the hospital. And the vagabonds from the Yaroslavl doss-house, who knew well what con-

стр. 103

sumption was from their own experience, collected 5 roubles 19 kopecks!

The Tuberculosis Institute was founded in Moscow in 1919 (now Institute of Pulmonology, I.M. Sechenov Moscow Medical Academy), then Central Recearch Institute of Tuberculosis, Russian Academy of Medical Sciences, was founded. It is noteworthy that the former institution occupies the complex of buildings of the Mariinsky Hospital for Poor People, built on donations of Maria Fyodorovna (1759 - 1828), dowager of Emperor Paul I. Fyodor Dostoevsky's father worked as a doctor there, and the great writer was born in one of the outbuildings of this hospital. The latter of these institutions is located on the grounds of the sanatorium opened on the money collected on a White Daisy Day.

In time a network of ТВ outpatient centers and hospitals spread all over Russia; great efforts were made to improve the social conditions of patients. Such efforts produced good results, for one, a decrease in ТВ incidence; but treatment of ТВ cases still remained ineffective by and large. The discovery of streptomycin, an antibiotic produced by microorganisms of the Actinomycetes group, came as a breakthrough. It was discovered in 1944 by Alexander Fleming, an English microbiologist and Nobel Prize Winner of 1945. While at the beginning of the 1940s the diagnosis of tuberculous meningitis in children was tantamount to a death sentence (infected babies died within several weeks), such cases could be cured with the new drug.

Other and more effective drugs were developed in time. Thus, Russian medics created an optimal system of ТВ control: intensive treatment at hospitals was backed by financial support and up-to-date equipment, long (up to several months) paid sick-leaves, free-of-charge sanatorial rehabilitation at the best health resorts of the country, and early detection of contacts of the infection carriers. It seemed that very soon we would be able to do away with tuberculosis for good. Hence a phasedown of social care for ТВ cases. In addition, ТВ agents (Mycobacteria) acquired drug resistance.

There came the moment of truth-an unexpected sharp increase in tuberculosis morbidity was registered. In 1993 the World Health Organization proclaimed tuberculosis a global hazard. Although control of this disease requires more financial investments, they pay off. For example, an increase in appropriate allotments in the USA led to a 25 - 30 percent drop of ТВ incidence during 1993 - 1995. Besides, special attention should be paid to drug supply and provision of laboratories with equipment, devices, and reagents.

We should remember that Mycobacterium tuberculosis is highly resistant to external factors: the infective activity of this bacterium persists for as long as 3 months in the open air and even longer in water (bacteria are detected in rivers 5 km downstream from places of sewage discharge from hospitals). The most incident species, hazardous for humans, can be transmitted to humans from cows (Mycobacterium tuberculosis, Mycobacterium bovis) and from birds (Mycobacterium avium). The hazards are many, especially in town, what with close contacts among people. However, everything depends on the immune defenses of each individual; the victims are usually debilitated persons sensitive to these agents.

In this country attention to tuberculosis control has increased during recent years: financing, drug supply, and provision of diagnostic equipment for specialized service has improved, while the therapeutic process is carried out by the traditional protocol described above, which proved its efficiency more than once. The output of ТВ drugs developed by Russian and foreign pharmacologists is in progress; consequently, doctors can use a combined rational drug therapy with due consideration of drug sensitivity to mycobacteria. As a result, the lung involvement process is stabilized in 80 percent of cases, while some patients can be prepared for routine surgery.

However, mortality from tuberculosis in Russia increased in 2005 more than 2-fold compared with 1992

стр. 104

Tuberculosis incidence in Russia in 1992 - 2005.

Number of registered HIV-infected cases in 2000 - 2005.

(22.1 cases per 100,000 of population), and it still persists, remaining the highest in Europe. This sad situation, particularly grave for men aged 45 - 54 years, is caused by the gradual accumulation of people with chronic forms of the disease and increased incidence of acutely progressive diffuse processes. Moreover, the efficiency of antibacterial therapy is on the decrease: the drug resistance of the causative agent increases, while the number of patients with drug intolerance increases. Males are infected three times as often as females, though girls under 14 years of age show a 10 - 12 percent higher incidence rate than boys.

What are the causes of the comeback of this old, almost forgotten disease? The key cause is in looser prevention. In 1985 - 1987 the topmost population numbers underwent special examinations (75 percent), while in 1993 - 1995 almost half of ТВ cases escaped detection. Preventive measures were resumed only in 1997 and now cover more than 58 percent of the population.

The "resurgence" of tuberculosis in Russia at the turn of the 21st century can be divided into 2 stages. During the first stage (1992 - 2000) a 2.5-fold increase in the disease incidence was recorded (from 35.8 to 90.4 cases per 100,000 of population-by an average of 16.9 percent annually), while during the second stage (2001 - 2004) the morbidity decreased by 6 percent. By the present time mortality values, including those for children and for men of all age groups, have stabilized. In other words, there are signs that the epidemic process has been checked.

The acquired immunodeficiency syndrome (AIDS) is considered to be the main cause for ТВ renaissance in industrialized countries: the immune system is much suppressed in HIV-infected patients, which makes them an "easy catch" for mycobacteria. A similar picture is seen in our country. True, the increase in the number of HIV carriers has slowed down somewhat in recent years, though the increase in their number among females is fraught with new hazards; this is explained by the emergence of a considerable mobile working force in the gray sphere of the Russian economy, the greater part of this force being women, and the ongoing expansion of the sex industry sphere. This feminization of AIDS became obvious even among very young patients: in 2005 girls aged 15 - 17 years were infected much more often than boys of the same age. While formerly the population of HI V-infected subjects consisted mainly of intravenous drug users, today this population includes primarily those involved in the sex industry, clients and partners alike. Let us note that more than half of new cases in 2005 were caused by unprotected sexual intercourse.

In a word, the efficiency of ТВ control depends not only on progress in diagnosis and treatment, but also on the healing of the social malaises of mankind.



Permanent link to this publication:

Similar publications: LRussia LWorld Y G


Libmonster OnlineContacts and other materials (articles, photo, files etc)

Author's official page at Libmonster:

Find other author's materials at: Libmonster (all the World)GoogleYandex

Permanent link for scientific papers (for citations):

Gennady POROSHENKO, TUBERCULOSIS: PROBLEMS STILL ON // London: Libmonster (LIBMONSTER.COM). Updated: 01.10.2018. URL: (date of access: 24.05.2019).

Publication author(s) - Gennady POROSHENKO:

Gennady POROSHENKO → other publications, search: Libmonster RussiaLibmonster WorldGoogleYandex


Reviews of professional authors
Order by: 
Per page: 
  • There are no comments yet
Libmonster Online
New-York, United States
204 views rating
01.10.2018 (235 days ago)
0 subscribers
0 votes

Related Articles
The first thing that inspired me to this discovery is the shock that the researchers of superconductivity experience. And this is understandable. If the conduction current is formed by free electrons, then why does superconductivity increase when free electrons practically disappear, freezing to atoms. Secondly, this is the obstinacy of the Russian scientist, Dr. Fedyukin Veniamin Konstantinovich, who doubted that superconductivity exists. He writes: “Proceeding from the general scientific, ideological position and practice that there is opposition to every action and there is resistance to any movement, it can be argued that resistance and electric current along the conductor should be. Therefore, the so-called "superconductivity" electric current is not, and can not be. "
Catalog: Physics 
15 days ago · From Gennady Tverdohlebov
According to our hypothesis, the conversion of electrons and positrons into each other occurs by replacing the charge motion vector with the opposite vector. This is explained by the fact that all elements of the electron's magnetoelectric system are opposite to all elements of the positron's magnetoelectric system. And this opposite is determined by the vector of their movement in space. Therefore, it is only necessary to change the motion vector of one of the charges to the opposite vector, so immediately this charge turns into its antipode.
Catalog: Physics 
68 days ago · From Gennady Tverdohlebov
Catalog: Military science 
82 days ago · From Libmonster Online
The article gives my short life story with a list of my discoveries. May the terrible moralists forgive me, I call these hypotheses discoveries because their logical connectedness and conformity with the materialistic dialectic of thinking does not allow to doubt that truth has been found here.
Catalog: Philosophy 
82 days ago · From Gennady Tverdohlebov
I wrote this article when I was 33, and I, who did not understand anything in physics, but who had logical thinking, were outraged by those alogisms and paradoxes that flowed from Einstein’s logic of relativity theory. But it was criticism at the level of emotions. Now, when I began to think a little bit in physics, and when I discovered the law of the difference of gravitational potentials, and based on it I built a five-dimensional frame of reference, it is now possible to prove the inaccuracy of Einstein’s theory of relativity at the level of physical laws.
Catalog: Physics 
89 days ago · From Gennady Tverdohlebov
Awareness of man himself, the birth of the human “I” occurred through a qualitative leap in the process of evolution of the population of brain giants, which appeared as a result of crossing Homo sapiens with Neanderthals.
Catalog: Science 
91 days ago · From Gennady Tverdohlebov
istory make the masses. But the masses are ruled by leaders. The influence of an individual on the development of social processes is the greater, the greater the influence this personality has on the consciousness of individuals, as well as on the social consciousness of groups, classes and nations. The formula of Marx's social progress — the developing productive forces of society outgrow their production relations, throw them off and give birth to new ones — true, but only with Lenin's amendment: man is the main productive force of humanity.
Catalog: Psychology 
91 days ago · From Gennady Tverdohlebov
The fundamental difference between a herd of animals and a human society is the presence of social laws formed by the consciousness of people in human society. Anthroposociogenesis is the process of forming into the consciousness of hominids of social laws, through the indefinite and combinational variability of genotypes with the elimination of those hominids that are not capable of subjecting their activity to laws.
Catalog: Science 
91 days ago · From Gennady Tverdohlebov
Comparing all that is united by the concept of "mine" with all that is united by the concept of "not mine" the concept of "I" is born. Here begins the development of the individual consciousness of modern man, here began the development and individual consciousness of fossil people. It also began its development and public power, which initially could not have any other form, as soon as the form of protection of a mother who realized her motherhood to her children. Both individual consciousness and public power originate in the form of legal consciousness, and, first of all, in the form of awareness of the issues of belonging of certain objects to certain individuals, that is, in the form of awareness of the concepts "mine is not mine", "my child is not my child".
Catalog: Psychology 
91 days ago · From Gennady Tverdohlebov
Dialectics is often called the tool of knowledge of nature. But, in the opinion of the author of this article, this tool is still as imperfect as the scissors would be imperfect, without the central screw uniting the two blades of this tool. This "cog" in dialectics is the fact that the "struggle" of opposites, which is the driving force behind the development of all processes of nature, is not absolute. "Struggle" is born when the dialectic system deviates from the state of equilibrium, and the goal of this "struggle" is to restore the lost equilibrium of the system.
Catalog: Philosophy 
92 days ago · From Gennady Tverdohlebov

Libmonster is a free tool to store the author's heritage. Create your own collection of articles, books, files, multimedia, and share the link with your colleagues and friends. Keep your legacy in one place - on Libmonster. It is practical and convenient.

Libmonster retransmits all saved collections all over the world (open map): in the leading repositories in many countries, social networks and search engines. And remember: it's free. So it was, is and always will be.

Click here to create your own personal collection

Support Forum · Editor-in-chief
Watch out for new publications:

About · News · Reviews · Contacts · For Advertisers · Donate to Libmonster

Libmonster ® All rights reserved.
2014-2019, LIBMONSTER.COM is a part of Libmonster, international library network (open map)