However, strictly scientific differentiation of living and nonliving meets certain difficulties items. So, there is still no consensus about whether human viruses that are outside cells of the host organism does not possess any of the attributes of the living: in the virus particle at this time there are no metabolic processes, it is not able to reproduce, etc.

The specificity of living things and life processes can be described as aspect of their financial structure and key features, underlying all manifestations of L. the Most accurate definition of life, embracing simultaneously both of these approaches to the problem, given about 100 years ago, the German philosopher, thinker and public figure, founder of Marxism Friedrich Engels: “Life is the mode of existence of protein bodies, and this method of existence consists essentially in a constant renewal of the chemical component parts of these bodies” (K. Marx and F. Engels, Soch., 2nd ed., vol. 20, p. 82). The term “protein” had not yet been determined quite accurately and it is usually attributed to the protoplasm as a whole.

All objects now known that possess the indisputable attributes of the living, are composed of two main types of biopolymers: proteins and nucleic acids (DNA and RNA). Conscious of the incompleteness of his definition, Engels wrote: “Our definition of life, of course, very insufficient, because it is far from being able to embrace all the phenomena of life, but rather is limited to the most common and simplest among them… to get a really comprehensive view of life, we would have to trace all the forms of its manifestation, from the lowest to the highest” (ibid., p.84).

English scientist, naturalist, traveler, Creator of Darwinism, foreign corresponding member Petersburg Academy of Sciences Charles Darwin in the last lines of the “Origin of species” writes about the basic laws which, in his opinion, the basis of the occurrence of all forms L.: “These laws, in the broadest sense of Growth and Reproduction, Heredity, almost must be derived from the playback Variability that depend on direct or indirect action of conditions of life and from exercises and neupaney, the Progression of reproduction is so high that it leads to a Struggle for life and its consequence Natural Selection…” (Soch., vol. 3, Moscow — Leningrad, 1939, p. 666). If we leave aside the role of exercise, which, according to later reports, is factor non-hereditary variability, a synthesis of Darwin remains in force today, and his basic laws of life are reduced to two even more General. It is primarily the ability of the living to assimilate received from outside the substance, i.e. to be transformed into the likeness of their own financial structures, and due to this many times to play them (to reproduce). In this case, if the initial structure is randomly changed (mutation), it continues in a new form.

Ability to excessive self-reference underlies cell growth, reproduction of cells and organisms and, hence, the progression of reproduction (the main condition for natural selection), as well as the basis of heredity and hereditary variability. Soviet biochemist V. Engelhardt Engelhardt was considered the reproduction of their kind as a fundamental property of the living, which now receives the interpretation in terms of chemical concepts on a truly molecular level. The other feature of live is the huge variety of properties acquired due to the variability of the material structures of living objects. Each of these two fundamental properties is mainly connected with the function of one of the two biopolymers. The “record” of hereditary properties, i.e., the encoding of characteristics of the organism, necessary for the reproduction, by using DNA and RNA, although in the process of reproduction necessarily involved proteins enzymes. Thus, living is not a single molecule of DNA, protein or RNA and their system in General.

Implementation of diverse information about the properties of the organism by synthesis according to the genetic code of various proteins (enzymatic, structural, etc.), which due to its diversity and structural plasticity contributes to the development of various physical and chemical adaptations of living organisms. On this Foundation, in the process of evolution has arisen unsurpassed in its perfection live control systems. Thus, life is characterized by a highly ordered material structures containing two kinds of biopolymers (protein and DNA or RNA) that make up a living system, capable as a whole to replicate itself on the principle of matrix synthesis. A characteristic feature of the chemical composition of the known forms L. — asymmetry of optically active substances, presented in live objects levorotatory or dextrorotatory forms.

Life is possible only under certain physical and chemical conditions (temperature, presence of water, some salts, etc.). However, the cessation of life processes, such as drying seeds, or deep freezing of small organisms, does not lead to loss of viability. If the structure remains intact, it is in the return to normal conditions ensures the restoration of vital processes.

Life qualitatively surpasses other forms of existence of matter in relation to the diversity and complexity of chemical components and the dynamics occurring in a living transformations. Living systems are characterized by a much higher order structural and functional, in space and in time. Structural compactness and energy efficiency of a living — the result of higher order at the molecular level. One important consequence of this compactness is a universal effect of the “gain”, characteristic of all living systems. As of 5∙10^-15 g DNA contained in the fertilized egg of the whale, is contained information for the vast majority of signs of the animal, which weighs 5∙10⁷ G. Here, therefore, if you have the necessary conditions, the weight increases by 22 fine. “It is the ability of the living to create order out of the chaotic thermal motion of molecules, — wrote Vladimir Aleksandrovich Engelgardt, is the most profound, fundamental difference between living from non-living. The tendency to organize, to create order out of chaos is nothing like countering the increase of entropy” (“Communist”, 1969, № 3, p. 85).

Living systems exchange with the environment energy, matter and information, i.e., they are open systems. In this case, unlike inanimate systems, and they does not correct the energy differences and the reorganization of the structures in the direction of more probable forms, and there is the opposite: restores the difference of energy potentials, chemical composition, etc., i.e. continuously going to work “against equilibrium” (Ervin Simonovich Bauer). This is based on the erroneous assertion that living systems allegedly do not obey the second law of thermodynamics. However, the local decrease in entropy in living systems is possible only by increasing entropy in the environment, so in General, the process of increasing entropy continues, which is consistent with the requirements of the second law of thermodynamics. In the figurative expression of the Austrian physicist Erwin Schrödinger, living organisms like to feed on negative entropy (negentropy), removing her from the environment and increasing the positive increase of entropy in it.

Life on Earth originated at least 1.5 — 2 billion years ago (see origin of life), presented with a huge number of organisms. Each organism can exist only under the condition of constant close contact with the environment, with other organisms and inanimate nature, and this relationship is bilateral. L. in all its manifestations has produced profound changes in the evolution of our planet, at least the outer shells. In perfecting the process of evolution, living organisms have been increasingly spread across the planet, taking an increasing part in the redistribution of energy and substances in the earth’s crust, and in air and water environments of the Earth.

The emergence and spread of vegetation has led to a radical change in the composition of the atmosphere originally contained very little free oxygen and consisting mainly of carbon dioxide and probably methane and ammonia. Plants assimilating carbon from CO₂, has led to the creation of an atmosphere that contains free oxygen and only traces of CO₂. Free oxygen in the atmosphere was not only active chemical agent, but also a source of ozone, block the path of the ultraviolet rays to the surface of the Earth (“ozone shield”). At the same time the carbon for centuries siplivaya in plant residues formed in the earth’s crust vast energy reserves in the form of deposits of organic compounds (coal, peat).

Vegetation cover changed the physical and chemical characteristics of the planet; changed, in particular, the reflectance of the land surface of various parts of the solar spectrum. The development of life in the oceans led to the creation of sedimentary rock composed of the skeletons and other remains of marine organisms. These deposits, their mechanical pressure, chemical and physical transformations changed the surface of the crust. Active selective absorption of substances by the organisms caused the redistribution of substances in the upper layers of the cortex. All this testifies to the presence on Earth of a special shell called the Soviet scientist, geochemist, Vladimir Ivanovich Vernadsky the biosphere, which was developed and continues to this day the phenomena of life.

In the course of evolution of living organisms is being continuously improved processes of regulation and their adaptation to external conditions, in freely moving animals has contributed to the development of the Central nervous system. Development is influenced by social labor the most advanced forms of higher nervous activity in human ancestors created the preconditions for life transition to a new social level associated with a new form of movement, human and qualitatively different from the biological, inherent in other forms of L., After the transition to this level, with the emergence of social consciousness, it becomes possible prediction of the development and creation of new forms of regulation and adaptations that are able to provide benefits that are impossible in the purely biological process of development. (Alexander A. Malinovsky, «Great Soviet Encyclopedia»)

Learn more about life read in the literature:

• F. Engels, Dialectics of nature, Marx Karl and F. Engels, Soch., 2nd ed., so Twenty;
• its the same Anti-dühring, ibid.;
• Lenin Vladimir Ilyich, Materialism and empiriocriticism, Full. Coll. soch., 5th ed., so Eighteen;
• In Vernadsky. I., the Biosphere, V. 1 — 2, l, 1926;
• Bauer E. S., Theoretical biology, Moscow — Leningrad, 1935;
• Schroedinger E., What is life from the point of view of physics?, translation from English., Moscow, 1947;
• Schmalhausen, Ivan Ivanovich, Cybernetic questions of biology, Novosibirsk, 1968;
• Malinovsky, A. A., Some questions of the organization of biological systems, in journal: Organization and management, Moscow, 1968;
• In Engelhardt., The problem of life in modern natural science, “Communist”, 1969, No. 3;
• L. fon bertalanfy. Problems of life, N. J., [I960].

Circulatory system by cells and tissues of the body supplied with nutrients and oxygen, and removed from the products of metabolism. Therefore, the circulatory system is sometimes called the transport or distribution, system.

In humans, the heart is located in the thoracic cavity asymmetrically: ¹/₃ it is the right of the median plane of the body, ²/₃ – on the left. The base of the heart facing up, back and to the right; tip – down, forward and to the left.

The rear surface of the heart adjacent to the diaphragm. Since it is surrounded on all sides with light, except for the front surface immediately adjacent to the chest wall (Fig. 1):

Fig. 1. Projection of the heart, the valves and large vessels on the anterior chest wall (semi-schematic): 1 – the trachea; 2 – right common carotid artery; 3 – brachiocephalic trunk; 4 – subclavian artery; 5 – subclavian Vienna; 6 – opening of the aorta (aortic semilunar valves); 7 – right atrioventricular orifice (tricuspid valve); 8 – external carotid artery; 9 – internal jugular Vienna; 10 – the thyroid gland; 11 – left brachiocephalic Vienna; 12 – aortic arch; 13 – pulmonary trunk; 14 – bronchi; 15 – hole pulmonary trunk (pulmonary artery valve); 16 – left atrioventricular orifice (mitral valve); 17 – apex of the heart.

In adults, the heart is the length of 12-15 cm, the transverse dimension of 8-11 cm anteroposterior size of 5-8 cm. The weight of the heart 220 – 300 g, is ¹/₂₁₅ of the body weight in men and ¹/₁₅₀ part – in women. Atrium – cavities, perceiving the blood from the veins. In the right atrium fall lower and upper vena cava carrying venous blood from the systemic circulation and the veins of the heart (including coronary sinus), the left – 4 pulmonary veins, which flows arterial blood from the lungs, oxygenated. Both are connected to the ventricles atrium atrioventricular openings which are closed in reducing ventricular flap valve. The inner surface of the crossbar and the ventricles are conical projections, called papillary muscles. From the tops of these muscles to the free edges of the flaps atrioventricular valves stretch tendon strings, preventing vyvёrtyvaniyu valve leaflets toward the atria.

At the base of the pulmonary trunk and aortic valve located pulmonary trunk and aortic valve. These valves consist of three semilunar cusps’s opening towards the respective vessels (Fig. 2), resulting in reductions of blood from the right ventricle of the heart enters the pulmonary trunk and the left of – the aorta (Fig. 3).

Fig. 2. Right (tricuspid) and left (mitral) atrioventricular valves. The valves of the aorta and pulmonary trunk (cross-sectional removed pulmonary trunk and aorta atrium; top view): 1 – pulmonary valve stem (crescent-shaped pockets); 2 – left annulus; 3 – left ventricle; 4 – left atrioventricular valve (mitral); 5 – aortic valve; 6 – Right annulus; 7 – right ventricle; 8 – right atrioventricular valve (tricuspid).

Fig. 3. Aortic valve (part of the wall of the left ventricle and the aorta bulbs cut and deployed): 1 – right coronary artery; 2 – aortic valve; 3 – the left ventricle (opened and deployed); 4 – papillary muscle; 5 – aorta (opened and deployed); 6 – left coronary artery; 7 – left atrioventricular valve; 8 – tendon strings.

The wall of the heart consists of three layers: the inner – endocardium, medium – infarction and outdoor – epicardium. Endocardium lines the cavity of the heart, is built of connective tissue containing collagen, elastic fibers and smooth muscle, blood vessels and nerves. On the free surface is covered with endocardium endothelium. Heart valves are the folds of endocardium. Myocardium – the thickest shell, divided into 2-3 layers. In atrial thickness reaches 2.3 mm in the right ventricle – 5.8 mm, left – 10-15 mm. The difference in thickness is associated with different functional load.

The myocardium is composed of striated muscle cells – myocytes. Their length varies from 50 to 120 microns, the width is equal to 15-20 microns. In the central portion 1-2 located myocyte nucleus. Contractile elements – myofibrils occupy the peripheral part of the sarcoplasmic. The ability of the heart to the continuous operation associated with mitochondria contained in myocytes – native enzymes involved in redox processes that provide cells with energy. Between adjacent myocytes are intercalated discs in which are combined into myocytes muscle fibers (Fig. 4):

Fig. 4. Schematic representation of the intercalated disks of cardiac muscle of mammals: A – a place close contact cell membranes of myocytes (nexus); B – the lateral edge portion of the muscle fiber, which have intimate contact between the membranes myocytes: gap separating membrane, according to the extracellular space.

Through the intercalated disks held excitation from one cell to another. Muscle fibers as atrial and ventricular start fibrotic heart rings surrounding the atrio-ventricular openings. Muscles of the atria, ventricles detached from the muscles, consists of 2 layers: the outer circular and deep longitudinal fibers which in folded cover the mouth of the vena cava draining into the atrium.

Muscles of the ventricles has three layers: the outer and inner – longitudinal, transverse between them – circular (Fig. 5).

Fig. 5. Muscle layers of the heart; left (deleted portions of the myocardium to show the location of its layers, pulmonary trunk and the aorta removed at their base): 1 – the external oblique layer; 2 – middle circular layer; 3 – deep longitudinal layer.

Partition between the ventricles constructed mainly of muscular tissue and it leaves the endocardial lining, except for the upper portion, where the ventricles are separated by only two sheets with a layer of fibrous endocardial tissue therebetween. At the heart of education contained atypical muscle tissue, the cells of which are poor and rich sarcoplasm myofibrils. The tissue forms the so-called cardiac conduction system made up of the sinoatrial node, located in the wall between the right atrium and the superior vena cava right eye; atrioventricular node, located in the wall between the atria of the right atrioventricular valve; atrioventricular bundle branch coming from the atrioventricular node in the interventricular septum. Bundle of His divides into right and left legs branching in the ventricular myocardium as the Purkinje fibers. The cells of the conduction system generate rhythmic excitation pulses and transmit them to the first atrial myocardium, and then on the myocardium of the ventricles, causing a reduction in series of chambers of the heart. Tightly to the epicardium and myocardium consists of connective tissue. Free its surface is covered mesothelium. At the base of the heart epicardium wrapped and goes into the pericardial sac – pericardium. Between the epicardium and pericardium is slit-like cavity containing a small amount of serous fluid friction reducing heart wall while it is running.

Blood supply to the heart is done right and left coronary arteries extending from the ascending aorta. Large veins of the heart are collected in coronary sinus, which flows into the right atrium, which coincide, moreover, and small veins. In the heart there is a dense capillary network, each muscle fiber is accompanied by capillaries. Lymph from the heart and mediastinal drains into the left tracheobronchial nodes.

Innervate the heart of wandering and sympathetic nerves. Located within the heart intracardiac ganglia containing the so-called efferent nerve cells that transmit impulses from them suitable fibers of the vagus nerve on the myocardium and coronary vessels. Furthermore, in the ganglia and heart are sensitive (afferent) nerve cells shoots which form closure sensitive devices (receptors) on the coronary vessels and the myocardium. These cells are in contact with intracardiac efferent neurons, forming intracardiac reflex mechanisms. (O.N. Aksenova)

On April 6, 1985, American^[ru] William Schroeder became the first person in the world to be discharged from the hospital with an artificial heart.

29 September is celebrated the world heart day (World Heart Day). It was first organized in 1999 on the initiative of the world heart Federation. This action was supported by the World health organization (WHO), UNESCO and other relevant organizations. Initially, the Day was held on the last Sunday of September, and since 2011 it has a fixed date-September 29.

Human health is determined by a complex biological (genetic and acquired) and social factors; the past are so important in maintaining health or to the origin and development of the disease that the preamble of the Charter of the World Health Organization says: “Health – a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” However, such a broad sociological definition of health is somewhat controversial, as the social usefulness of a person does not always coincide with his biological condition.

In general, the concept of health is somewhat arbitrary and objectively established jointly anthropometric, clinical, physiological and biochemical parameters determined by taking into account gender, age factors, as well as climatic and geographical conditions.

Health should be characterized not only qualitatively but also quantitatively, as there is a concept of its extent, determined by the breadth of adaptation (adaptive) of the body. Although health is a state opposite to the disease^[ru], it may be associated with it various transition states and not have clear boundaries.

Health status does not exclude the presence in the body has not yet manifested pathogenic start or fluctuations in subjective well-being. Due to these features, the notion “almost human health”, at which the pathological changes in the body do not affect the well-being and not reflected in human performance. However, lack of manifesting health disorders may not indicate the absence of the disease state, as overvoltage protective-adaptive mechanisms, without breaking health can lead to the development of the disease on the body when exposed to extreme irritants.

The factors determining the health of the population, include the value of real wages, working hours, the degree of intensity and working conditions, the presence of occupational hazards, the level and nature of food, housing, lifestyle, state of health and the health of the country. Unambiguous criterion by which one could judge the state of health of the inhabitants of a country, virtually non-existent; even such a complex index, as life expectancy, by itself, without taking into account the complex socio-biological research, is not sufficient to assess the west population. Scientific organization of health of individuals and human communities must be based on improving the protective properties of the body of people, as well as on creating conditions that prevent the possibility of human contact with different pathogenic stimuli, or to reduce their effects on the body.

Soviet health every effort to develop, maintain and strengthen human health. This was facilitated by a preventive nature of Soviet medicine, free, accessible and efficient treatment, a wide network of medical institutions, sanatoriums and rest homes, mass organization of physical culture and sports.

The structure of the eye

The eyeball has a spherical shape. The central point of the front surface of the eye called the anterior pole, a point located on the rear surface, in the place of origin of the optic nerve – the posterior pole. The line connecting the poles of the eye is taken for an anatomical axis, it coincides with the geometrical axis. In the front, facing the light of the eye is located diopter (light-refracting) apparatus (refractive media system, which includes the cornea (See. The cornea), a transparent lenticular lens – the lens, aqueous humor and filling the cavity of the eye vitreous, as well as serving to accommodate the ciliary body and iris, or the iris), transmitting the image on a photosensitive retina (See. Retin-A), or retina.

The wall of the back of the eyeball consists of three shells, tightly adjacent to each other. The dense outer shell – the sclera – has a supporting and protective value; it gives the eye shape being like a skeleton. At the open front side of the eye, the sclera becomes thin and transparent cornea. Under the sclera is richly endowed with blood vessels choroid, the front of which is in the form of a thin plate forms the iris, which has a hole in the middle – the pupil. In the tissue of the iris in most vertebrates are special muscles – sphincter and dilator that, expanding and narrowing the pupil to regulate entry into the eyes of the light rays, and the iris, ie. A., Plays the role of the diaphragm.

Of pigmentation of the iris containing pigment cells – chromatophores – and transmission through the transparent cornea, eye color depends. If there are no chromatophores, or outer layer of the retina is devoid of pigment, the iris shine through the blood vessels of the choroid and eyes are red (see. Albinism). Painting of the iris sometimes varies depending on the age, sex and animal habitats (dark color eyes of many young birds and bright in old or milky-white color of the iris in young and orange-yellow in older, for example, in goshawk). Behind the iris ciliary body located – ring roller containing muscle fibers. To him using fiber bundles Zinn suspended bag lens. Reduction of ciliary body causes in most vertebrates change in curvature of the lens, ie. E. The accommodation (See. Accommodation) (adaptation of the eye to the distant or near vision).

The inner shell photosensitive eye – the retina. At the posterior pole of the eye is yellow spot; somewhat closer to the center line of it is land, devoid of sensitivity to light – a blind spot. At this point is collected from the entire retinal nerve fiber of the optic nerve as extending further into the brain. Different classes of vertebrate eye has a number of characteristics.

The fish eye cornea is totally flat and spherical lens:

Eye of fish (pike longitudinal section of the eye): 1 – the retina; 2 – pigment layer; 3 – choroid; 4 – the optic nerve; 5 – the lens; 6 – supporting ligament of the lens; 7 – muscle to move the lens; 8 – the tendon of the lens; 9 – Iris; 10 – cornea; 11 – the sclera; 12 – silver shell.

In the cavity of the eye juts from the choroid special crescent process containing smooth muscle fibers that attach to the bag of the lens. Thus, the accommodation of the eye in fish is achieved by moving the lens. In the back of the choroid often contains a special layer of cells filled with crystals of light pigment so-called silver shell. Some fish have a shiny layer – mirror (tapetum) that reflects light rays back to the retina, resulting in an apparent glow eyes of some fish in almost complete darkness (eg sharks). In some deep-sea fish eyes are reduced, while others are well adapted to capture faint light underwater depths – huge, telescopic eyes.

Four-eyed fish pupils have elongated in the vertical direction; cornea is divided by a horizontal bar in the upper and lower sections. When the fish floating on the surface, the upper part of her eye is able to survey the air environment, the bottom – water.

Amphibians cornea differs big bulge:

Eye amphibian (frog eye longitudinal section): 1 – the lower oblique muscle of the eye; 2 – inferior rectus muscle of the eye; 3 – the lower eyelid; 4 – muscle, attracting the lens; 5 – the optic nerve; 6 – nictitating membrane; 7 – pupillary muscles; 8 – scleral cartilage; 9 – superior oblique muscle; 10 – upper rectus; 11 – the upper eyelid; 12 – Zinn fiber.

In the iris and ciliary body has an underdeveloped musculature; Accommodation of the eye by moving the lens by means of a special muscle, attracting the lens forward to the cornea, as well as by the pressure of ciliated muscle.

In reptiles (Fig. 1), excluding the Gutter and the turtles, and birds (Fig. 2), except for kiwis, vitreous juts from the entrance of the optic nerve outgrowth characteristic, abundantly supplied with blood vessels, – crest. Visual apparatus of birds in many respects superior to the eyes of other animals. The eyeball has a very large size and unique structure, thereby increasing the field of view. Birds that have particularly keen eyesight (vultures, eagles), the eyeball is elongated “telescopic” form. In the retina, there are up to three yellow spots.

Fig. 1. Eye reptile (snake eyes longitudinal section): 1 – the muscles of the iris; 2 – the front wall of the lens; 3 – cornea; 4 – ciliary body with muscles; 5 – suborbital scales; 6 – the sclera; 7 – supraorbital scales; 8 – fused eyelids; 9 – Zinn bunch.

Fig. 2. Eye of a bird of prey (longitudinal section): 1 – the cornea, sclera in passing; 2 – choroid; 3 – ciliary body; 4 – vitreous; 5 – Iris; 6 – the lens; 7 – the optic nerve; 8 – ridge; 9 – retina; 10 – the sclera; 11 – front camera.

The mammalian eye in its form approaches to the eyes of amphibians. In aquatic mammals (eg, whales) it is the convexity of the cornea and a high refractive index resembles the eyes deep-sea fish. In carnivores, pinnipeds and kitoooraznyh the inner surface of the choroid forms, as well as a number of fish, the brilliant pigment layer – mirror.

Reduced eyes are in cave fish and amphibians (eg Proteus); living in underground mammals (eg, moles) they differ or deep bedding under the skin, or the lack of the lens, iris and some layers of the retina.

On April 21, 1969, the first human eye transplant took place. The transplant took place in Houston, Texas. Doctors^[ru] transplanted an eye from a donor who died^[ru] from a brain tumor to 54-year-old John Madden. But, unfortunately, the eye did not take root and after 9 days the bleeding started, as the donor organ did not take root.

Song «Your eye» — Alexander Malinin:

(Article from the Russian “Great Soviet Encyclopedia”, punctuation in the original):

Physicians are trained medical school. Persons who have graduated from foreign medical school, physicians have the right to work in the USSR after the state examinations and examinations for those courses that are not taught in foreign schools. Persons who have experience of medical work, as well as persons with a scientific degree are admitted to medical work by special permission of the Ministry of Health ^[ru] (no exams).

Activities of physicians in a socialist state consists of curative and preventive work aimed at improving the environment, working and living conditions of the population. The doctor is guided by medical ethics, which includes the concept of the physician’s duty. Working in a hospital, the doctor must maintain patient confidentiality. It is the duty of the doctor – first aid. Soviet legislation criminalizes the failure to assist a patient unexcused persons obliged to provide such assistance under the law (the RSFSR Criminal Code, Art. 128). If the person did not have a medical staff necessary patient care in the performance of their duties, they are held accountable both for malfeasance. Doctors involved also in private practice, are required to register in a special book an overview of the patients, as well as all-purpose and manufactured manipulation.

Doctors in the field are divided into physicians (internal medicine), Pediatrics (pediatricians), surgeons, gynecologists (for women’s diseases), radiologists, neurologists (on nervous diseases), psychiatrists (for mental illness), dermatologists (for skin and venereal diseases ), dentists (for diseases of the mouth and teeth), otolaryngologists (ear disease, nose and throat), TB specialists (for tuberculosis), oncologists (for tumor diseases), trauma (for various injuries), orthopedic (on diseases of musculoskeletal motion), and others.

For proper use of physicians and improve their skills in the USSR practiced certification of doctors. Qualification is determined by a special commission. Higher qualification is assigned a doctor with experience in the profession for at least 10 years old, having a high theoretical and practical training. Depending on qualifications and seniority doctors set wages.

In capitalist countries, medical care is provided mainly by private practitioners; in some countries, certain types of medical care provided free of charge in hospitals owned or charities. (Y.I. Rodov.)

March 30 – National Doctor’s Day in the USA^[ru]

For the first time, the celebration of the (National Doctor’s Day) in the United States, which is now celebrated annually on March 30, in 1991 after the approval of the lawful approval of this holiday was approved by Congress and the Senate in 1990.

The resolution on its creation was signed on October 30, 1990 by US President George W. Bush. For the first time the Doctor’s Day was celebrated on March 30, 1933, in Winder, Georgia. The idea of “celebrating Doctor’s Day” belongs to Ehodore Elmond – the wife of Dr. Charles Elmond. The first celebration of Doctor’s Day was marked by sending out greeting cards for doctors and laying flowers on the graves of the departed doctors.

The symbol of the Doctor’s Day in America is the red carnation. To celebrate the holiday on this day was proposed to mark the anniversary of the first application of general anesthesia by an American physician and pharmacist Crawford Long (1815-1878) in 1842. On March 30, 1958, the US House of Representatives approved a resolution establishing the Doctor’s Day.

Oath of the doctor of the Russian Federation

When I receive the high rank of doctor and begin my professional career, I solemnly swear:

• Honestly fulfill their medical duty, to devote their knowledge and skills to the prevention and treatment of diseases, preservation and promotion of human health;
• To be always ready to render medical aid, to keep medical secret, to treat carefully and carefully the patient, to act exclusively in his interests irrespective of sex, race, nationality, language, origin, property and official position, a residence, the relation to religion, beliefs, belonging to public associations, and also other circumstances;
  Show the highest respect for human life, never resort to the implementation of euthanasia;
• To keep gratitude and respect to the teachers, to be exacting and fair to the pupils, to promote their professional growth;
• To treat colleagues kindly, to ask them for help and advice if the interests of the patient require it, and to never refuse to colleagues help and advice;
• Constantly improve their professional skills, protect and develop the noble traditions of medicine.

Celebrity quotes about love:

Jean de La Bruyere:

A good doctor is a person who knows the remedies for certain ailments or, if the disease is unknown to him, calls to the patient those who can help him.

Osho:

When you are ill, call a doctor. But most importantly, call those who love you, because there is no medicine more important than love^[ru].

March 30-national doctor’s day in the United States

The first celebration of National doctor’s day in the United States^[ru], which is now celebrated annually on March 30, took place in 1991 after the Congress and the Senate approved the legal approval of this holiday in 1990.

The resolution on its establishment was signed on October 30, 1990 by US President George Bush. The first doctor’s Day was celebrated on March 30, 1933, in Winder, Georgia. The idea of celebrating the day of the doctor belongs to Eodora Almond-the wife of Dr. Charles almond. The first doctor’s day celebration was marked by sending greeting cards to practitioners and laying flowers on the graves of deceased doctors.

The symbol of doctor’s Day in America is a red carnation. Celebrate the holiday on this day was proposed to commemorate the anniversary of the first use of General anesthesia by the American doctor and pharmacist Crawford long (1815-1878) in 1842. On March 30, 1958, the U.S. House of representatives approved a resolution establishing doctor’s Day.

March 30-national doctor’s day in the United States
The first celebration of National doctor’s day in the United States (national Doctor’s Day), which is now celebrated annually on March 30, took place in 1991 after the Congress and the Senate approved the legal approval of this holiday in 1990.

The resolution on its establishment was signed on October 30, 1990 by US President George Bush. The first doctor’s Day was celebrated on March 30, 1933, in Winder, Georgia. The idea of celebrating the day of the doctor belongs to Eodora Almond-the wife of Dr. Charles almond. The first doctor’s day celebration was marked by sending greeting cards to practitioners and laying flowers on the graves of deceased doctors.

The symbol of doctor’s Day in America is a red carnation. Celebrate the holiday on this day was proposed to commemorate the anniversary of the first use of General anesthesia by the American doctor and pharmacist Crawford long (1815-1878) in 1842. On March 30, 1958, the U.S. House of representatives approved a resolution establishing doctor’s Day.

See also — the Text of the Hippocratic oath in Russian.

For more information about the specialty read^[ru] in the literature:

• Artemyev FA, legislation on health management of the USSR^[ru], Moscow, 1955;
• N.A. Semashko, On Ethics Soviet doctor, “Hygiene and Sanitation”, 1945, № 1 – 2;
• Gruber G. V., Arzt und Ethik, B., 1956.

There are 2 forms of ophthalmia: newborns and adults. Infection in most cases, neonatal ophthalmia occurs during the passage of the fetal head through the birth canal of the mother with gonorrhea. O. appears on 2 – 3rd day of life and is characterized by a very strong first edema of both eyelids after 2 – 3 days begins copious pus. In severe cases, the process may be involved in the cornea, formed ulcer healing scar and leave a thorn. In some cases, the disease leads to blindness.

Sometimes occurs in newborns like illness Infections caused by a virus. It develops, in contrast to O., not before the 5th day of life and flows more slowly and less severely, the cornea in the process is never involved.

Infection ophthalmia adults occurs when entering the eye^[ru] with gonococcal urogenital hands, household items by patients suffering from gonorrhea. O. in adults is more severe than in infants, usually affected only one eye.

Treatment: frequent eye wash with a weak solution of potassium permanganate, antibiotics.

Prevention: the fight against gonorrhea urogenital tract. Newborn immediately after birth for ever let in both eyes, one drop of a 2% solution of silver nitrate or penicillin for adults – good personal hygiene. When a unilateral process is very important to prevent other eye disease ^[ru], for which the healthy ^[ru] eye pressure garment to wear a watch glass.

The most important general symptoms of anemia – fatigue, pale skin, shortness of breath, dizziness, tendency to faint. A. caused by three main factors: blood loss, impaired hematopoiesis, and increased kroverazrushenie.

A. associated with acute blood loss develops with wounds, gastrointestinal, pulmonary, nasal, uterine, less renal hemorrhage. A. At this suddenly appear sharp pallor, dizziness, tinnitus, thirst. It will not be life-threatening conditions, one should immediately stop bleeding that often requires surgical intervention, use styptics, blood transfusions.

A common cause of anemia – deficiency in iron, so iron is called A. Iron is part of hemoglobin and red blood cell enzymes involved in cellular respiration and is almost out of the body. Iron deficiency is caused by a small, but frequent blood loss (heavy and prolonged menstrual periods, bleeding hemorrhoids, etc.). A. very often this develops, if chronic blood loss combined with reduced secretion of gastric juice, which can reduce the absorption of iron in food. A. iron deficiency often occurs in children in the first year if the mother lacked the iron in the body. A. the same form is sometimes found in premature infants who did not manage to obtain the necessary amount of iron from the mother. A. iron deficiency may develop during puberty in girls born to mothers with iron deficiency in the body – juvenile chlorosis (“chlorosis” greensickness). For chlorosis, in addition to general attributes, A., characteristic hair loss, brittle nails, taste perversion (the desire to eat chalk, tooth powder, coal, slate from pencils), micturition disorders (bed wetting, frequent urge to urinate). Treatments for iron A. conduct various preparations of iron in combination with ascorbic acid (in this combination are better absorbed).

There are forms of anemia in which the body enough iron, but it is not fully used for the formation of hemoglobin due to the decreased activity of enzymes that form hemoglobin (sideroahresticheskaya A.). A. These are hereditary or associated with lead poisoning. When these forms of A. has a curative effect vitamin B6. Treats lead poisoning. Violation of blood formation is observed with a deficiency of vitamin B₁₂ (vitamin deficiency B₁₂, anemia Addison – Biermer, old name – A pernicious, pernicious anemia). A. the reason for this – a violation of the stomach making a special protein – gastromukoproteina (biermerin) providing intestinal absorption of vitamin B₁₂. A lack of vitamin B₁₂ in the body may be in patients who in the past has been removed the entire stomach, and also in patients with parasitic infestations, particularly broad tapeworm. When B₁₂ vitamin deficiency in the body is disturbed formation of ribonucleic acid (RNA) needed for cell reproduction. As a result of broken blood, red blood cells increase in size, their number in blood volume decreases. Due to the increase of the epithelial cells of the epithelium changes the structure of language, what is connected with his pain, and sometimes the spinal cord is affected. In 1926 he was invited to this form of anemia raw liver, from which was subsequently isolated vitamin B₁₂ – the main remedy for anemia Addison-Biermer.

Hemodyscrasia, expressed in the perversion of education in the bone marrow progenitor cells that form red blood cells, white blood cells and platelets, leading to the development of hypoplastic and aplastic A. For hypoplastic A characteristic decrease in the number per unit volume of blood red cells, white cells and platelets. In this form of anemia have a therapeutic effect hormones (glucocorticoid and male sex hormones), sometimes – removal of the spleen. Also used bone marrow transplantation.

Hemolytic anemia caused by increased hemolysis (destruction of red blood cells). Usually red blood cells live about 120 days. When the patient’s own antibodies against erythrocyte lifespan of red blood cells is much shorter. There is a rapid destruction of a large number of red blood cells due to the decaying of hemoglobin in patients are icteric staining tissues (jaundice). Developing immune hemolytic A., which is used to treat hormonal drugs (glucocorticoid hormones). Sometimes the birth of the child develops an acute hemolytic A., due to incompatibility of blood between mother and child (hemolytic disease of the newborn). Of hemolytic A. significant place hereditary forms. Their development is associated with a genetic dysfunction of enzymes involved in the formation of red blood cell membranes, or the accumulation of the energy necessary for their livelihoods and conservation of the shell.

In hereditary hemolytic anemia treatment effect sometimes makes removal of the spleen. In hereditary deficiency in the erythrocytes of certain enzymes (dehydrogenase, glucose-6-phosphate, etc.) lose their ability to counteract the harmful effects on vital cell processes of individual drugs, certain foods and other substances. In these patients, after administration of even small doses of acetylsalicylic acid (aspirin), streptotsida, quinine, by eating certain legumes and even if swallowed pollen of these plants have severe hemolytic A., which is more common in people living in Africa, of the Mediterranean basin, and in the CIS countries – in the southern republics.

In those geographic areas are common hereditary anemia associated with violation of the synthesis of the protein hemoglobin. A. These forms are called hemoglobinopathies. Red blood cells in some forms of the disease have sickle-shaped (crescent A.), sometimes – the target (mishenevidnokletochnaya A.).

Treatment of all types of anemia can be conducted only after a precise diagnosis and form A.).

The development of a common understanding of disease changed over the history of medicine. The ancient Greek physician and reformer of ancient medicine Hippocrates cause of the disease is considered misuse of mixing four basic body fluids: blood, phlegm, yellow and black bile (venous blood). Around the same time, based on the atomistic theory of ancient Greek materialist philosopher Democritus, the idea arose that the disease develops as a result of changes in the shape of atoms and their incorrect arrangement. At the end of the old and the beginning of a new era, and especially in the Middle Ages, idealistic views on the doctrine of the disease, according to which the soul or a special kind of life force (“Archean”), defines the struggle of the body to changes caused by boleznfmi.

Materialistic views on the disease in the Middle Ages developed by Ibn Sina (occurrence of the disease under the influence of invisible beings, the role of the constitution of the body). In the 17th – 19th centuries, a great contribution to the study of the disease have an Italian physician and anatomist Giovanni Battista Morgagni (the thought of illness due to anatomical changes in the organs), a French doctor, one of the founders of Pathological Anatomy and Histology, Marie Francois Xavier Bichat (description of the pathologic picture series diseases), the German pathologist Rudolf Virchow (theory of cellular pathology), C. Bernard (disease – a violation of physiological equilibrium with the environment) and other Russian therapist Sergei Petrovich Botkin, founder Viktor Pashutin Pathophysiology, Russian physiologist Ivan Petrovich Pavlov (Иван Петрович Павлов) and therapist Alexey Ostroumov disease associated with violation of the conditions of human existence and developed the idea of the disease on the basis of ideas nervism.

Despite the abundance of work on disease, the concept is still not precisely determined. Some authors deny the qualitative features of the disease as compared with health [ru]. Thus, the pathophysiology Alexander Bogomolets expressed the idea that the disease in the body does not produce anything really new. Others include the concept of a biological disease patterns. By PD Gorizontov’s disease is a common complex reaction that occurs as a result of violations of the relationship of the body and the environment. The disease is accompanied by the development of pathological processes from local manifestations of the general reaction of the body. In the writings of the Russian pathologist and founder of the scientific school of Hippolytus Vasilyevich Davydov upheld the provision that there is no fundamental difference between the physiology and pathology. Pathological processes and disease, in his opinion – it’s just a particular adaptive processes associated with subjective suffering. According to the concept of Canadian pathologist Hans Selye’s general adaptation syndrome, disease is stress (“stress”) that occurs in the body when exposed to extreme stimulus.

Causes of disease

Causes of disease are varied, but they can all be grouped under the mechanical, physical, chemical, biological, and for a man – and even psychogenic factors. Any of these factors is the state of the disease, if it is inadequate (ie, emergency, unusual) for the body. Inadequacy may be quantitative (amount of stimulus is excessive for the body), qualitative (the body is influenced by factors in relation to the quality of which is not produced in the body protective-adaptive mechanisms), temporary (quantitatively and qualitatively adequate stimulus affects long-term or at such intervals and in this rhythm, which are unusual for the body) and depending on the individual properties of the organism (ie, defined by individual reactivity of the organism in the form of increased sensitivity).

In today’s presentation of the disease is characterized by the following main features:

• 1. In the development of the disease plays a major role the external environment, and for the people – primarily social. Changes in the intrinsic properties of the body caused by environmental factors and firmly fixed (including and hereditary mechanisms), hereinafter themselves can play a leading role in the development of disease (see Medical Genetics).
• 2. Important in the development of disease than the etiological factor (that is, the causes of the disease) and external conditions are protective and adaptive mechanisms of the body. Development of diseases largely depends on the perfection of these mechanisms, the volume and speed of their inclusion in the disease process. The man on the development and course of disease is greatly influenced by psychogenic factors.
• 3. Disease – the suffering of the whole organism. There is a completely isolated diseased organs and tissues, as the local disease. With any disease to a greater or lesser extent, involved the entire body, which does not exclude the presence of the primary lesion in a particular organ or body part.

Distinguish the following periods of the disease: hidden, or latent (for infectious diseases – the incubation), – the period between the beginning of the impact of the pathogenic agent and the appearance of the first symptoms. It can last from a few seconds (for example, in cases of poisoning by strong poisons) to decades (eg, leprosy).

Prodromal period – the period of the first signs of the disease, which may be indefinite nonspecific (fever, fatigue, malaise), or in some cases, be representative of the disease (eg, stains Filatov – Koplik with measles). The period of full development of the disease, the duration of which varies from several days to dozens of years (tuberculosis, syphilis, leprosy).

Completion period of disease (recovery, convalescence) can occur quickly or gradually critically, analytically. Depending on the duration of the course and speed of the rise and disappearance of symptoms of diseases are acute and chronic joining the main manifestations of the disease additional changes not related to the immediate cause of the disease, but developing as a result of its flow is called a complication. It can occur in the midst of sickness and minovanii main manifestations. Complications aggravate illness, and sometimes can become a cause of adverse outcome. Outcome of the disease may include: complete recovery, recovery with residual or persistent change in organs, sometimes the emergence of new forms of the disease in the form of long-term effects, and death. Death as the end of the disease may occur suddenly, after a brief agony or gradually, through a more or less prolonged agonal state.

Classification of human diseases carried by the nature of the flow (acute and chronic diseases), and the level at which the body identifies specific pathological changes in disease (molecular, chromosomal, cellular and tissue, organ, disease of the whole organism), and etiological factor (disease caused by mechanical, physical, chemical, biological or psychogenic factors), and the method of treatment (medical, surgical, etc.), by age or gender differences (women, children), etc.

The most accepted is the nosological principle, that is, a classification of the disease, which is based on the grouping of diseases on related grounds. It should be noted that none of the existing classifications of disease is not fully satisfactory. Thus, when classification nosological principle pneumonia, for example, can be attributed to diseases of the respiratory system, to infectious diseases and allergic conditions. Therefore the creation of the modern classification of the disease is the most important task of theoretical and practical medicine.

The skin consists of an outer (epithelial) and internal (connective tissue) layers separated by a basal membrane and often forming numerous derivatives (see Fig. 1, 2, 3).

Fig. 1. The structure of the skin insect (scheme): 1 – epicuticle; 2 – exocuticle; 3 – epidermis; 4 – trihogennaya (hair) cell; 5 – connective cells; 6 – basement membrane of the epidermis; 7 – hair; 8 – endocuticle.

Fig. 2. Structure of the skin bony fish (scheme): 1 – rich glandular cells of the epidermis; 2 – bony scales; 3 – connective tissue layer.

Fig. 3. Structure of the skin of a mammal (the scheme): 1 – hair; 2 – the horny layer of the epidermis; 3 – other layers of the epidermis; 4 – papillae of the outer layer of the dermis, jutting out into the epidermis; 5 – sebaceous glands; 6 – sweat glands; 7 – fatty subcutaneous tissue; 8 – reticular layer of the dermis.

Epithelial layer of a large diversity of single-or multi-cellular glands. Solid products of epithelial excretions may serve as skeletal and protective elements (shells of mollusks, enamel scales of sharks). Products of degeneration of the cytoplasm of epithelial cells form a chitinous shell – the skeleton of arthropods and body chemical and mechanical protection – the cuticle of parasitic worms to counter the activity of digestive enzymes of the host intestine. Unlike invertebrates, having a layer of cells in the epithelium, S., multilayered epithelium in vertebrates, and at the vertebrate cells of the outer layers are completely horny degenerate and form a constantly renewed horny layer of the epidermis (see Fig. 4), horny scales, hair, feathers, claws and more. Desquamation of horny cells helps to cleanse the skin of dirt.

Fig. 4. The structure of mammalian epidermis (the scheme): 1 – basal layer; 2 – layer ribbed; 3 – granular layer; 4 – shiny layer; 5 – horny layer; 6 – basement membrane; 7 – fiber papillary dermis; Н – the “grain” keratohyalin; Ф – fibrils; Я – the nucleus of cells; O – thorny process of cell layer.

Stratum corneum of higher vertebrates and arthropods chitinous shell allows many of them to withstand the withering work atmosphere in a terrestrial lifestyle. Hair and feathers, keeping body heat, contribute to some mammals and birds maintain active life^[ru] even at t temperatures below 0° C. Connective tissue layer, or dermis, forming a network of collagen and elastin fibers that give skin strength and elasticity (in vertebrates, cephalopods), and other bone and scales (fish) and dermal ossification (reptiles), playing the role of armor.

In the adult area of the skin is 1.5-2 m². The thickness of the various parts of the body varies from 0.5 to 4 mm. In the epithelial layer (epidermis) S. distinguish layers: basal, ribbed (comprising germ or Malpighian, layer), grainy, shiny and horny, and in the lower layers of the epidermis are sensitive. Exfoliated cells of the horny layer are replaced by shifts to the surface cells of the basal layer. So called layers – the stage of conversion (differentiation) of cells in the basal layer of the horn.

Differentiation is accompanied by a loss of the ability of cells to multiply and accumulation of fibrils prokeratina, that is the finest beams (50 – 80) filaments of fibrous protein with a molecular weight of about 640 000. Next, in close contact with the fibrils appear “grain” keratohyalin, ie clusters of fibrous protein. Their appearance is associated with accelerated synthesis prokeratina. Granular cells and brilliant layers include a large amount of sulfur-containing amino acids, and almost entirely filled with keratin and die off. Keratin filaments represented about 75 thick, immersed in an amorphous protein. Numerous SH-groups of molecules of keratin oxidation closed in intermolecular S – S-moctiki. Keratin is about ²/₃ the weight of the stratum corneum cells and is characterized by high chemical resistance.

Complete upgrade of the epidermal cells is about 20 days. In most mammals, and humans epidermis forms sebaceous, sweat glands, mammary glands and hair. Secretion of sebaceous glands (sebum) lubricates the epidermis and hair, making them water-repellent. Sweat glands are involved in thermoregulation, allocating up to several liters of sweat per day, the evaporation from the surface of which S. removes excess heat and prevents overheating of the body. Since then leave the body and part of the products of metabolism, especially urea, which is of particular importance in renal disease.

The dermis distinguish two layers: papillary, adjacent to the epidermis, and the mesh and deeper. The first images of the different forms of papillae and ridges jutting into the epidermis and determine the design surface of the skin. Papillary layer, along with connective tissue cells contain a loose network of thin collagen and elastin fibers and smooth muscle fibers. Last involved in the regulation of heat transfer. Reticular layer of dense connective tissue before forming a network of relatively thick bundles of collagen and elastin fibers, oriented parallel to and at oblique angles to the surface of S. mesh layer immersed deep sections of hair follicles and glands.

The epidermis and dermis may contain pigment cells that protect the fabric from UV rays and give skin a different, some animals easily changed, painting. S. blood vessels in the deeper layers form a skin arterial network, from which depart the vessels in the surface layer. The lymphatic system consists of true lymphatic vessels in the papillary dermis associated with papillar and subcutaneous lymphatic network.

A huge number of sensory nerve endings located in S., provides quick response to the changing external environment. On 1 cm² of skin surface pain points is 100 – 200, tactile sensitivity – 25, cold – 12 – 15 and the heat – 1-2. The greatest sensitivity is S. palmar surface, the fingertips and the tip of the nose. S. surface, especially at the fingertips, covered a complex pattern, which is strictly individual and age does not change (on this property based skin forensic science – fingerprinting).

One of the main functions of human skin – thermoregulation. About 80% of the heat transfer occurs through S. convection, evaporation and radiation. S. diffuse through almost all gases. However, skin respiration (oxygen and removing carbon dioxide) is only 1 – 1.5% of the total gas exchange.

Plays a significant role in skin metabolism – water-salt, carbohydrate, protein, enzyme, etc. Through S. absorbed some substances that are soluble in fats and volatile liquids, based on what the effect of certain drugs used topically, and ointments. S. inseparably linked with the life of the whole body – the various dysfunctions of organs and systems often affect the state S. (itching, burning, redness, rashes and other reactions), and, conversely, the disease^[ru] S. cause a reaction of the body (for example, burn disease).

Read more about the skin in the literature:

• And A Small House. I., Fundamentals of Spaniel anatomy of vertebrates, 4 ed., Moscow, 1947;
• Not the dermatology manual, vol. 2, L., 1961;
• Histology, under red. V. G. Lisa, M., 1963;
• In Beklemishev. N., The basics of Spaniel anatomy of invertebrates, 3rd ed., vol. 2, M., 1964;
• Pavlov S. T., Case, veneer disease, 2nd ed., L., 1969;
• Mercer. N… Keratin and keratinization: essay on molecular biology, Oxf., 1961;
• W. Montagna, structure and function of skin, 2nd ed. N. I., 1962;
• Biology of skin and hair growth, ed. A. G. hull and B. F. Korotkikh, Sydney, 1965.