Work of an In-patient Department

16. The Blood Vessels, Large and Small

The raw materials for the energy that powers man's every thought and action transported in the blood. The enriched blood is carried in a network of all vessels, capillaries, to each cell. There are so many capillaries in the body that, laid end to end, they would ring the equator more than twice.
Blood coming into the capillaries from the arteries has been enriched with oxygen in the lungs or with food from the digestive system. The walls of the capillaries are only one cell thick; so thin that oxygenated blood is able to pass its oxygen and food to the body's cells and to receive from the cells their waste. The spent blood then flows from the capillaries into the veins, which direct it back to the heart. In the heart the blood enters the arteries and is carried by them to the lungs and digestive system, to be oxygenated and enriched again before returning to the capillaries.
The body's largest blood vessels, the aorta and the pulmonary artery, are about an inch in diameter. Arteries have thick elastic walls, the pulsations of which assist the heart in pumping. Vein walls are more rigid. Many of them, particularly in the lower part of the body, have valves which prevent a backflow of blood.

17. Polyclinics

The state has established a wide network (тизим) of medical institutions to protect the health of people. One of such medical institutions is the polyclinic.
If a person falls ill he will ring up his local polyclinic and call in a doctor. When his condition isn't very poor and he has no high temperature he will go to the local polyclinic and a physician will examine him there.
Many specialists including therapeutists, neurologists, surgeons and others work at the polyclinic. During the medical examination a physician usually asks the patient what he complains of and according to the complaints carries on the medical examination. The physician listens to the patient's heart and lungs and measures his blood pressure and if necessary asks the patient to take the temperature. The laboratory findings which include blood analysis, the analysis of urine (urinalysis) and other tests help the physician to make a correct diagnosis and administer a proper treatment.
In addition to their consulting hours at the polyclinic local physicians go out to the calls to examine those patients who are seriously ill and whose condition is bad. Such sick persons receive a sick-leave. They usually follow a bed regimen.
Any physician of the polyclinic knows his patients very well because he treats only a definite number of patients. At the local polyclinic every patient has a personal patient's card which is filled in by his physician. Everything about the patient - the diagnosis of the disease, the administrations made by the doctor, the course of the disease, the changes in the patient's condition after the treatment are written down in the card.
If it is necessary a nurse will come to the patient's house to give him the administered injections or carry out any of the doctor's administrations.

. A Case of Bronchitis

Patient Karimov called in a physician from the local polyclinic. He could not go to the polyclinic himself because his temperature was about 38°C. In a few hours doctor Rasulova, an experienced therapeutist, came to the call.
Doctor Rasulova wanted to know the patient's complaints. When the patient was being questioned by the physician on his condition he said that a short, painful dry cough associated with rapid respiration had developed two days before. In addition to that the patient complained of the pain both in the throat and behind the breastbone.
While the patient was being examined the physician listened to his heart and lungs and then measured his blood pressure. Neither the blood pressure nor the heart sounds were abnormal. But both dry and moist rales were heard in the lungs. The respiratory rate was considerably increased and the patient breathed with difficulty. The physician also determined that the patient felt discomfort in the chest.
On the basis of all the findings the physician made the diagnosis of acute bronchitis in a mild form. She thought it was neither a catarrh nor a cold. The amount of the discharge from the bronchial mucous membrane was large. It accumulated in the bronchial tubes and made the patient cough. Passing through this fluid in the bronchial tubes the air which was breathed in and out produced moist and dry rales.
It was not necessary to admit the patient to the hospital, he was allowed to follow home treatment. The patient had to be on a sick-leave until his temperature became normal and all the symptoms were controlled. He was to follow a bed regimen and a light diet. He was also recommended to drink either warm milk or have warm applications to his chest. These procedures had to control the cough and impaired breathing.
The doctor administered the patient two tablets of tetracyclin to be taken orally and a cough mixture to be taken three times a day.

19. Tracheitis

Tracheitis [treiki'aitis] is the disease in which the mucous membrane of the trachea [ ] is impaired. The disease usually develops in a weak organism, after a person has been in the cold environment for a long period of time, or after some infectious disease.
In such conditions the microorganisms such as pneumococci, staphylococci and streptococci which usually invade the upper respiratory tract, multiply rapidly and produce the inflammation of the mucous membrane.
The main symptom of tracheitis is the cough, usually dry at first. But in a day or two it becomes productive. After the attack of cough the patient feels pain in the substernal area and in the throat. The general condition becomes worse. When the attacks of cough are particularly long, a bad headache may develop. In the adults the temperature may not be high, but in the children it may be as high as 39°C.
The patient with tracheitis usually follows home treatment receiving a sick-leave for the period of his disease. The patient must be in a warm room well aired. He may be administered aspirin or codein which gives some relief. He may also be recommended to have warm milk with soda several times a day.

20. At a Chemist's

As you know on receiving a prescription from a doctor or on following a home treatment all of us need medicines which are ordered or bought at a chemist's.

There are usually two departments in a large chemist's. At the chemist’s department one can have the medicine immediately, other drugs have to be ordered at the prescription department.
At any chemist's all the drugs are kept in drug cabinets. Every small bottle , a tube or a box of medicine has a label on it. White labels indicate drugs for internal use, yellow ones indicate drugs for external use and blue ones indicate drugs used for injections. The dose to be taken and the directions for the administration are also indicated on a label. Indicating the dose and the name of any medicine is necessary for chemists, nurses,doctors and patients themselves. It prevents confusing (to confuse- адаштирмок) different remedies, some of which are poisonous. Their overdosage may cause unfavourable reactions and sometimes even death.
At a chemist's one can buy different drugs for intramuscular and intravenous injections, for oral administration and for external use.
Before using the medicine the patient must know well that he is taking the proper drug and in the necessary dosage.

21. Microorganisms

All the existing microorganisms can be divided into two main groups - aerobic and anaerobic. Aerobic microorganisms must have atmospheric free oxygen for their life and growth. However one knows that free oxygen is not favourable for the development of anaerobic microorganisms.
Bacteria vary in shape and according to this feature they are divided into some groups. Spherical bacteria have been called cocci. They are also subdivided into several groups. Rod-shaped (таёкчасимон) bacteria are called bacilli.
When bacteria multiply they divide. The growing organism increases in size up to a certain limit and in due time divides. The process of division depend on the conditions of the environment.
Any minute [mai'nju:t] (майда) virulent microorganisms may invade the human body. But due to the local protective agents of the human organism they are destroyed. In this case no disease occurs.
However the local protective agents of the human organism are not always able to destroy completely the invading microorganisms. It is known that in such a case a local or general infection may occur.
Most of the microorganisms produce diseases when they enter the tissue and destroy it. If one examines under the microscope the alveoli of the lung of the man with lobar pneumonia a great number of pneumococci can be revealed.
While the disease persists the lung may be considerably impaired because of the consolidations which may develop in it.
But the human organism can fight against the microorganisms which have passed its first protective barriers, i.e. skin and mucous membranes.
The prominent Russian scientist I.I.Mechnikov had made many investigations before he was able to come to the conclusion that leucocytes could catch and destroy certain microbes. I.I. Mechnikov called them phagocytes or microbe cell destroyers.

22. Robert Koch

Robert Koch is a prominent German bacteriologist, the founder of modern microbiology. He was born in 1843, died in 1910. When Koch became a doctor he carried on many experiments on mice (сичконлар) in a small laboratory.In 1882 Koch discovered tuberculosis bacilli. In his report made in the Berlin Physiological Society Koch described in detail the morphology of tuberculosis bacilli and the ways to reveal them. Due to his discovery Koch became known all over the world. In 1884 Koch published his book on cholera. This book included the investigations of his research work carried out during the cholera epidemic in Egypt and India. From the intestines of the men with cholera Koch isolated a small comma-shaped (вергулсимон) bacterium. He determined that these bacteria spread through drinking water. In 1905 Koch got the Nobel prize for his important scientific discoveries.