1
00:00:00,080 --> 00:00:01,920
FILM LABORATORY

2
00:00:02,080 --> 00:00:04,760
OF THE SETCHENOV 1st
MOSCOW MEDICAL INSTITUTE

3
00:00:04,920 --> 00:00:05,920
1979

4
00:01:05,000 --> 00:01:06,360
<i>These children</i>

5
00:01:06,520 --> 00:01:11,040
<i>will never be beautiful, healthy</i>
<i>and complete human beings.</i>

6
00:01:11,200 --> 00:01:12,960
<i>Here's the reason why:</i>

7
00:01:13,160 --> 00:01:17,040
<i>their parents suffer </i>
<i>from a severe illness called syphilis.</i>

8
00:01:18,600 --> 00:01:19,600
SYPHILIS

9
00:01:24,520 --> 00:01:25,440
MEDICAL RECORD

10
00:01:25,600 --> 00:01:27,560
<i>A young man with no occupation,</i>

11
00:01:27,720 --> 00:01:30,240
<i>a medical student, a maid,</i>

12
00:01:30,400 --> 00:01:34,640
<i>a chancellor, a cook, a civil servant,</i>

13
00:01:34,800 --> 00:01:37,480
<i>a tradesman, an estate agent,</i>

14
00:01:38,800 --> 00:01:41,120
<i>a nobleman, a bailiff,</i>

15
00:01:41,280 --> 00:01:45,480
<i>a servant, a duke, a housekeeper.</i>

16
00:01:45,640 --> 00:01:48,880
<i>In pre-Revolutionary Russia,</i>
<i>all classes</i>

17
00:01:49,080 --> 00:01:52,280
<i>were exposed</i>
<i>to this dangerous disease.</i>

18
00:02:01,000 --> 00:02:03,360
<i>Because of their dissolute ways,</i>

19
00:02:03,560 --> 00:02:07,960
<i>shameful contamination</i>
<i>did not spare royal nobility.</i>

20
00:02:19,680 --> 00:02:20,880
<i>Syphilis</i>

21
00:02:21,600 --> 00:02:25,840
<i>and the other venereal diseases</i>
<i>spread mainly from brothels.</i>

22
00:02:26,880 --> 00:02:29,240
<i>According to statistics,</i>
<i>1 prostitute out of 5</i>

23
00:02:29,760 --> 00:02:31,040
<i>had syphilis.</i>

24
00:02:31,520 --> 00:02:35,600
<i>From the brothels,</i>
<i>the disease flooded all of Russia</i>

25
00:02:35,800 --> 00:02:37,120
<i>in abject waves.</i>

26
00:02:44,280 --> 00:02:45,360
<i>World War I</i>

27
00:02:45,560 --> 00:02:49,760
<i>and the Allied intervention</i>
<i>in the Civil War weakened</i>

28
00:02:49,960 --> 00:02:52,520
<i>already inadequate medical surveillance.</i>

29
00:02:53,080 --> 00:02:55,200
<i>Among the health problems</i>

30
00:02:55,400 --> 00:02:59,040
<i>the young Soviet Republic was facing:</i>

31
00:02:59,240 --> 00:03:00,320
<i>syphilis.</i>

32
00:03:01,160 --> 00:03:02,480
<i>Archives,</i>

33
00:03:02,640 --> 00:03:05,080
<i>case reports and photographs</i>

34
00:03:05,280 --> 00:03:07,760
<i>paint a tragic picture</i>

35
00:03:07,960 --> 00:03:10,040
<i>of the devastating effects of syphilis</i>

36
00:03:10,240 --> 00:03:12,680
<i>for thousands of people.</i>

37
00:03:12,880 --> 00:03:15,840
<i>Some of the outwards signs of syphilis</i>

38
00:03:16,040 --> 00:03:20,280
<i>can only be found in textbooks today.</i>

39
00:03:41,720 --> 00:03:43,360
<i>By stamping out prostitution,</i>

40
00:03:43,520 --> 00:03:46,360
<i>creating a vast network</i>
<i>of medical institutions,</i>

41
00:03:46,520 --> 00:03:49,520
<i>and carrying out</i>
<i>health education initiatives,</i>

42
00:03:49,720 --> 00:03:53,920
<i>the Soviet State put an end to syphilis</i>
<i>as a social disease.</i>

43
00:03:54,080 --> 00:03:55,840
<i>But in recent years,</i>

44
00:03:56,040 --> 00:03:58,000
<i>the medical community</i>

45
00:03:58,160 --> 00:04:01,440
<i>has once again been faced</i>
<i>with this almost forgotten foe.</i>

46
00:04:10,600 --> 00:04:12,960
<i>The infectious agent is well known:</i>

47
00:04:13,120 --> 00:04:14,280
<i>Treponema pallidum</i>

48
00:04:14,480 --> 00:04:16,160
<i>or spirochete,</i>

49
00:04:16,320 --> 00:04:19,000
<i>discovered in 1905</i>

50
00:04:19,200 --> 00:04:20,320
<i>by Fritz Schaudinn.</i>

51
00:04:20,480 --> 00:04:25,600
<i>Treponema enters the body</i>
<i>mainly through sexual contact,</i>

52
00:04:25,760 --> 00:04:28,200
<i>but also in other ways.</i>

53
00:04:28,360 --> 00:04:30,280
<i>The incubation period</i>

54
00:04:30,520 --> 00:04:33,480
<i>lasts 25 to 35 days.</i>

55
00:04:33,640 --> 00:04:38,200
<i>The primary stage of the condition</i>
<i>occurs within 6 to 8 weeks.</i>

56
00:04:38,480 --> 00:04:40,240
<i>The secondary stage</i>

57
00:04:40,400 --> 00:04:41,960
<i>lasts 2 to 4 years.</i>

58
00:04:42,120 --> 00:04:46,520
<i>The tertiary stage,</i>
<i>the most severe, follows later.</i>

59
00:04:50,160 --> 00:04:51,560
<i>After contamination,</i>

60
00:04:51,720 --> 00:04:55,040
<i>syphilis immediately spreads</i>
<i>throughout the whole body.</i>

61
00:04:55,200 --> 00:04:58,080
<i>However, its clinical manifestations</i>

62
00:04:58,240 --> 00:05:01,760
<i>can only be detected</i>
<i>after the incubation period.</i>

63
00:05:01,920 --> 00:05:04,600
<i>The 1st symptom of the primary stage</i>

64
00:05:04,760 --> 00:05:08,040
<i>develops where the treponemata</i>
<i>entered the body.</i>

65
00:05:08,200 --> 00:05:09,840
<i>It is called a chancre.</i>

66
00:05:10,600 --> 00:05:12,160
<i>It looks like an erosion</i>

67
00:05:12,360 --> 00:05:15,320
<i>or a round ulcer</i>

68
00:05:15,480 --> 00:05:18,720
<i>with smooth edges</i>
<i>and a shiny pink-red floor,</i>

69
00:05:18,880 --> 00:05:20,960
<i>raising</i>

70
00:05:21,160 --> 00:05:23,880
<i>over the surrounding skin.</i>

71
00:05:24,040 --> 00:05:26,920
<i>Around the base of the erosion or ulcer,</i>

72
00:05:27,080 --> 00:05:29,160
<i>a typical indurated infiltration</i>
<i>is felt.</i>

73
00:05:33,720 --> 00:05:35,400
<i>A chancre</i>

74
00:05:35,600 --> 00:05:39,120
<i>can appear anywhere</i>
<i>on the skin and mucous membranes.</i>

75
00:05:39,280 --> 00:05:40,880
<i>It can be found</i>

76
00:05:41,040 --> 00:05:44,480
<i>wherever treponemata</i>
<i>entered the body.</i>

77
00:05:55,040 --> 00:05:57,280
<i>Depending on the location,</i>

78
00:05:57,440 --> 00:06:00,800
<i>the aspect, outline</i>
<i>and size of a chancre</i>

79
00:06:00,960 --> 00:06:02,800
<i>can vary.</i>

80
00:06:02,960 --> 00:06:05,920
<i>Cervical chancres</i>

81
00:06:06,080 --> 00:06:09,040
<i>form a limited, red, granular erosion.</i>

82
00:06:09,200 --> 00:06:13,000
<i>Erosive hard chancres</i>
<i>spontaneously cover with epithelium,</i>

83
00:06:13,160 --> 00:06:14,040
<i>if not treated.</i>

84
00:06:15,360 --> 00:06:19,200
<i>Chancres on the pubis</i>
<i>and abdomen are large,</i>

85
00:06:19,360 --> 00:06:24,160
<i>and ulcerative forms</i>
<i>may persist for a long time,</i>

86
00:06:24,320 --> 00:06:28,120
<i>until the rash breaks out</i>
<i>in the secondary stage of the disease.</i>

87
00:06:37,640 --> 00:06:39,680
<i>A chancre always comes</i>

88
00:06:39,840 --> 00:06:42,480
<i>with the 2nd clinical sign</i>
<i>of primary stage syphilis:</i>

89
00:06:42,680 --> 00:06:44,160
<i>the local bubo,</i>

90
00:06:44,320 --> 00:06:47,400
<i>an inflammation of nearby lymph nodes.</i>

91
00:06:49,720 --> 00:06:54,000
<i>For some time now,</i>
<i>we have observed in the primary stage</i>

92
00:06:54,160 --> 00:06:58,640
<i>the presence</i>
<i>of multiple ulcerative chancres.</i>

93
00:07:29,000 --> 00:07:31,480
<i>In the event of a secondary infection,</i>

94
00:07:31,640 --> 00:07:35,960
<i>a chancre's clinical presentation</i>
<i>may vary.</i>

95
00:07:36,120 --> 00:07:38,920
<i>Complications in men</i>

96
00:07:39,080 --> 00:07:40,560
<i>can be phimosis</i>

97
00:07:40,800 --> 00:07:41,760
<i>and paraphimosis.</i>

98
00:07:41,920 --> 00:07:45,920
<i>They impede the diagnosis</i>
<i>of primary stage syphilis,</i>

99
00:07:46,080 --> 00:07:49,120
<i>even more so because inguinal nodes</i>

100
00:07:49,280 --> 00:07:52,400
<i>can become painful, immovable, adherent,</i>

101
00:07:52,560 --> 00:07:55,360
<i>and the skin above them drops.</i>

102
00:07:55,520 --> 00:07:59,480
<i>In case of erosive lesions</i>
<i>of the genitals and mucous membranes, </i>

103
00:07:59,640 --> 00:08:03,200
<i>one should always consider</i>
<i>a syphilitic infection.</i>

104
00:08:21,600 --> 00:08:24,720
<i>Due to its variety</i>
<i>of clinical manifestations,</i>

105
00:08:24,880 --> 00:08:28,400
<i>syphilis used to be called</i>
<i>"the great imitator".</i>

106
00:08:28,600 --> 00:08:30,480
<i>The secondary stage rash</i>

107
00:08:30,640 --> 00:08:34,880
<i>is remarkable for the diversity</i>
<i>of its morphological traits.</i>

108
00:08:35,040 --> 00:08:38,200
<i>It may be maculose, papular,</i>

109
00:08:38,360 --> 00:08:41,320
<i>vesicular or pustular syphilides.</i>

110
00:08:41,480 --> 00:08:44,800
<i>During that period, typical breakouts</i>

111
00:08:45,000 --> 00:08:48,320
<i>are ubiquitous, abundant</i>

112
00:08:48,480 --> 00:08:51,440
<i>and of a dull blue-red colour.</i>

113
00:08:59,360 --> 00:09:03,240
<i>One of the prevailing</i>
<i>characteristics of syphilis</i>

114
00:09:03,400 --> 00:09:05,200
<i>is that breakouts are often located</i>

115
00:09:05,360 --> 00:09:07,200
<i>on the palms and soles.</i>

116
00:09:07,400 --> 00:09:11,320
<i>They are palmoplantar variants</i>
<i>of secondary stage syphilis.</i>

117
00:09:11,520 --> 00:09:14,080
<i>The breakouts look like blotches,</i>

118
00:09:14,240 --> 00:09:15,840
<i>lenticular and annular papules,</i>

119
00:09:16,040 --> 00:09:19,440
<i>and syphilitic keratoderma.</i>

120
00:09:19,600 --> 00:09:21,400
<i>Most diagnostic errors</i>

121
00:09:21,560 --> 00:09:26,000
<i>occur at the secondary stage.</i>

122
00:09:39,480 --> 00:09:43,120
<i>Syphilitic papules</i>
<i>on oral mucous membranes</i>

123
00:09:43,280 --> 00:09:46,600
<i>are whitish because of maceration.</i>

124
00:09:46,760 --> 00:09:50,160
<i>The loose epithelium</i>
<i>of syphilitic genitalia</i>

125
00:09:50,320 --> 00:09:53,360
<i>at the secondary stage, erodes easily</i>

126
00:09:53,560 --> 00:09:54,600
<i>and desquamates.</i>

127
00:09:54,760 --> 00:09:57,880
<i>Erosive syphilis</i>
<i>is particularly contagious.</i>

128
00:10:09,920 --> 00:10:13,040
<i>In very humid areas</i>
<i>and with constant friction,</i>

129
00:10:13,200 --> 00:10:15,400
<i>the look of the papules changes.</i>

130
00:10:15,560 --> 00:10:18,720
<i>Not only do they macerate,</i>
<i>they also proliferate,</i>

131
00:10:18,880 --> 00:10:22,720
<i>forming thick raised papules</i>
<i>and large condylomata.</i>

132
00:10:22,880 --> 00:10:24,560
<i>This type of lesion</i>

133
00:10:24,720 --> 00:10:28,160
<i>is the most characteristic one</i>
<i>of recurring secondary syphilis.</i>

134
00:10:37,240 --> 00:10:41,240
<i>At the secondary stage,</i>
<i>pigmentary syphilide</i>

135
00:10:41,400 --> 00:10:45,600
<i>is the equivalent of a positive</i>
<i>Wassermann test drawn on the neck.</i>

136
00:10:51,360 --> 00:10:53,640
<i>Every doctor should know</i>

137
00:10:53,800 --> 00:10:56,920
<i>that alopecia warrants</i>
<i>a Wassermann test.</i>

138
00:10:57,080 --> 00:10:59,880
<i>Generally, leucoderma</i>
<i>and specifically alopecia</i>

139
00:11:00,040 --> 00:11:03,240
<i>appear 5 to 6 month after infection.</i>

140
00:11:08,560 --> 00:11:13,760
<i>Tertiary syphilis occurs</i>
<i>after a latency period.</i>

141
00:11:13,920 --> 00:11:17,120
<i>The Sword of Damocles</i>
<i>always hangs above the head</i>

142
00:11:17,280 --> 00:11:20,320
<i>of a non or badly treated patient.</i>

143
00:11:20,480 --> 00:11:22,720
<i>It can fall at any given moment.</i>

144
00:11:22,880 --> 00:11:24,880
<i>Tertiary syphilis usually appears</i>

145
00:11:25,040 --> 00:11:27,800
<i>4 to 5 years after contamination.</i>

146
00:11:27,960 --> 00:11:30,480
<i>Trauma, chronic illness,</i>

147
00:11:30,640 --> 00:11:34,280
<i>drug or alcohol abuse</i>
<i>contribute to its development.</i>

148
00:11:34,440 --> 00:11:37,840
<i>At this stage, clinical signs</i>
<i>such as tubercles and gummata,</i>

149
00:11:38,000 --> 00:11:42,680
<i>may appear on the skin,</i>
<i>in subcutaneous tissue, in muscles,</i>

150
00:11:42,840 --> 00:11:44,680
<i>bones and internal organs.</i>

151
00:11:44,840 --> 00:11:47,720
<i>There are few tertiary syphilides.</i>

152
00:11:47,880 --> 00:11:50,160
<i>They are not insignificant though</i>

153
00:11:50,320 --> 00:11:54,600
<i>as they always leave</i>
<i>mosaic or star-shaped scars.</i>

154
00:12:16,600 --> 00:12:19,280
<i>When they are located</i>
<i>on mucous membranes,</i>

155
00:12:19,440 --> 00:12:22,160
<i>tertiary syphilis ulcers</i>

156
00:12:22,320 --> 00:12:25,200
<i>destroy both soft tissues</i>
<i>and the skeletal system</i>

157
00:12:25,360 --> 00:12:27,080
<i>deeply and widely.</i>

158
00:12:53,360 --> 00:12:54,320
<i>In many countries,</i>

159
00:12:55,200 --> 00:12:57,680
<i>health professionals</i>
<i>and social scientists</i>

160
00:12:57,880 --> 00:13:00,640
<i>worry about the propagation of syphilis.</i>

161
00:13:00,840 --> 00:13:04,080
<i>The causes of these new waves</i>
<i>of venereal diseases are</i>

162
00:13:04,280 --> 00:13:06,440
<i>young people's early independence,</i>

163
00:13:06,640 --> 00:13:08,960
<i>migration, alcoholism,</i>

164
00:13:09,120 --> 00:13:09,920
<i>ignorance</i>

165
00:13:10,120 --> 00:13:12,240
<i>of sexual hygiene,</i>

166
00:13:12,400 --> 00:13:13,960
<i>the loosening of marital ties,</i>

167
00:13:14,160 --> 00:13:16,480
<i>too much free time, tourism,</i>

168
00:13:16,720 --> 00:13:19,240
<i>the culture of sex</i>
<i>and pornography in movies, </i>

169
00:13:19,440 --> 00:13:21,880
<i>television, advertising and newspapers.</i>

170
00:13:22,480 --> 00:13:25,040
<i>Promiscuity</i>

171
00:13:25,440 --> 00:13:27,600
<i>and casual relationships</i>

172
00:13:27,840 --> 00:13:29,560
<i>ruin people's health</i>

173
00:13:29,720 --> 00:13:30,640
<i>and cause</i>

174
00:13:30,840 --> 00:13:33,000
<i>infertility and family drama.</i>

175
00:13:34,520 --> 00:13:36,960
MALARIA - MENINGITIS

176
00:13:37,120 --> 00:13:40,640
<i>"Nowadays, current dreadful illnesses</i>
<i>such as malaria</i>

177
00:13:40,800 --> 00:13:43,600
<i>"meningitis,</i>
<i>tuberculosis and hepatitis</i>

178
00:13:43,760 --> 00:13:46,720
<i>"are far behind syphilis</i>

179
00:13:46,880 --> 00:13:51,640
<i>"as far as number of cases go",</i>

180
00:13:51,800 --> 00:13:55,520
<i>stated venereologist</i>
<i>at the 1st Moscow Medical Institute,</i>

181
00:13:55,680 --> 00:13:56,720
<i>Robert Babaiants.</i>

182
00:13:57,880 --> 00:14:03,680
Naturally, the worldwide ravages 
of venereal diseases

183
00:14:04,720 --> 00:14:06,720
are bound to affect us all.

184
00:14:06,880 --> 00:14:10,440
Due to foreign communication
and contacts,

185
00:14:10,600 --> 00:14:12,680
and a few other issues,

186
00:14:12,840 --> 00:14:16,880
we need to focus
all our efforts and resources

187
00:14:17,040 --> 00:14:19,640
on prophylaxis.

188
00:14:21,240 --> 00:14:25,760
The USSR does not have the social roots
that give rise to venereal disease

189
00:14:25,920 --> 00:14:29,880
but we must remain highly vigilant.

190
00:14:32,960 --> 00:14:34,280
<i>Here is a case study</i>

191
00:14:34,440 --> 00:14:36,880
<i>in a dermatovenereology clinic.</i>

192
00:14:37,320 --> 00:14:40,760
<i>A young man came in</i>

193
00:14:40,920 --> 00:14:43,560
<i>a few weeks after a one night stand.</i>

194
00:14:45,320 --> 00:14:48,480
<i>The examination found syphilis.</i>

195
00:14:49,040 --> 00:14:52,320
<i>The patient was drunk</i>
<i>during intercourse.</i>

196
00:14:53,280 --> 00:14:55,520
<i>He only remembers</i>

197
00:14:55,720 --> 00:14:59,240
<i>the woman's name, not her address.</i>

198
00:14:59,400 --> 00:15:01,640
<i>His description of the neighbourhood</i>

199
00:15:01,800 --> 00:15:04,840
<i>is insufficient for social services</i>

200
00:15:05,000 --> 00:15:07,600
<i>to locate the source of the illness.</i>

201
00:15:08,120 --> 00:15:09,640
<i>The clinic's head doctor,</i>

202
00:15:09,840 --> 00:15:13,200
<i>eager to prevent other people</i>

203
00:15:13,360 --> 00:15:14,760
<i>from falling ill,</i>

204
00:15:15,000 --> 00:15:16,360
<i>starts his investigation.</i>

205
00:15:16,960 --> 00:15:19,080
<i>The lack of information</i>

206
00:15:19,280 --> 00:15:22,440
<i>turns this case into a detective story.</i>

207
00:15:44,920 --> 00:15:47,600
<i>The doctor's perseverance bears results.</i>

208
00:15:47,760 --> 00:15:49,040
<i>He finds the woman.</i>

209
00:15:49,720 --> 00:15:51,800
<i>She is immediately sent to the hospital.</i>

210
00:15:52,160 --> 00:15:53,560
<i>Later it turns out</i>

211
00:15:53,720 --> 00:15:56,240
<i>that she did not know she was ill,</i>

212
00:15:56,400 --> 00:15:58,680
<i>and had not noticed any symptom</i>

213
00:15:58,840 --> 00:16:02,600
<i>because she was taking antibiotics</i>
<i>for minor reasons.</i>

214
00:16:02,760 --> 00:16:04,720
<i>Promiscuity:</i>

215
00:16:05,880 --> 00:16:08,480
<i>that is how one person can become</i>

216
00:16:08,640 --> 00:16:12,960
<i>the source of contamination</i>
<i>of dozens of others.</i>

217
00:16:28,720 --> 00:16:32,200
SCRIPTWRITER: Dr B. ZOUDINE

218
00:16:32,600 --> 00:16:38,440
SCIENTIFIC CONSULTANT:
PROFESSOR R. BABAIANTS

219
00:16:38,800 --> 00:16:41,120
CINEMATOGRAPHER: V. SOSNINE

220
00:16:41,280 --> 00:16:43,720
ANIMATOR: B. CHANI
WRITER: L. PANOVA

221
00:16:43,880 --> 00:16:47,800
SOUND ENGINEER: Z. KAUROVA
EDITOR: A. BELOBOKOV

222
00:16:48,200 --> 00:16:49,360
THE END