« PreviousContinue »
September, 1912, page 409, we mentioned the good. Have had patient under care most of time receipt by us of a clipping from the Kalamazoo for nearly a year and we are getting discouraged. Gazette in which a woman of that town recom- Have tried dieting her, and as she is a lover of mended the oil of collie puppies for tuberculosis. sweets, have cut them practically out. Any help It reminds us of a patient dying of gastric carcinoma you can give me will be appreciated. who asked her niece, a young lady who had been Stella, Neb.
E. I. WHITEHEAD. cured of tuberculosis at a tuberculosis sanatorium, (First eliminate the constipation by continuous if she thought the aunt herself might be cured by
use of an aperient, and we have never found any. going there. Neither the patient nor the niece knew what ailed the elder woman; but the young
thing better than Drysdale's—one or two every
night on retiring. See that not enough are taken to woman was expected to give medical advice on
produce catharsis-very few need to take more the subject. Thus the laity gives and takes "advice"
than one tablet each night. on medical topics without considering whether the Next, instruct her carefully in oral hygiene, if adviser is capable of speaking on the subject. she is negligent in this matter. Let the teeth be Dog fat would have no more effect on tuber
thoroly cleansed just before retiring. Use a mouth culosis than any other fat. Fat is a food of greater
wash afterward of some mild antiseptic, such as value than most people appreciate. Read our
peroxid of hydrogen or liquor antisepticus, N. F. editorial on “Fat as a Food," in March WORLD. Touch the ulcerations with the solid stick of In that article we called attention to Dr. Kendall's
silver nitrate every two or three days until they treatment of tuberculosis by feeding his patients disappear. Attack new ones with the caustic on cream.-ED.)
immediately on their appearance.
For a time, put her on 2 teaspoonfuls of elixir Drysdale's Aperient.-Cough Syrup. lactated pepsin, 80 grains to the ounce, before Dear DR. TAYLOR:—Please give the formula
meals. Also, we should think a thoro course of for Drysdale's tablets. I have been having excellent
Blaud's pill indicated.-ED.) results in chronic coughs with the following: R Linseed oil..
Dr. L. R. Emerick, of Conover, Ohio, inquires Water..
which preparation of lobelia gives the best reChloral hydrate.
sults, hypodermically used, in asthma ? Also if Codein. .
anyone has had any success in treating cataract Syrup. prun. Virgin., q. s. ad... ...oz. iv
with succus maritima. M. Sig. - Teaspoonful every 3 hours. Have you any suggestion to make as to quantity
MEDICAL FRAUDS. of ingredients?
JAMES H. KENNEDY. Aberdeen, Md.
Croney's Epilepsy Remedy. (Drysdale's aperient tablets contain:
EDITOR MEDICAL WORLD:- I have patient, age R Rhubarb
12, boy, that has had epilepsy for six years. Aloes, aā,
Family History: One aunt died of paralysis at Ipecac.
.5/12 grain 30. One greatuncle died of epilepsy; grandmother, Nux vomica.
neurasthenia. So long as results are satisfactory, why bother
I have tried everything and nothing does him about change in the proportion of ingredients? any good but for a few weeks. His father has been You could measurably increase both the codein
trying Dr. Croney's “Specific for Epilepsy,” put and the chloral, if you found any cough intract
up at Columbus, Ohio, and sold for $5 a pint. able.-Ed.)
He says it has helped him more than anything.
Can you give me the formula for it and do you Snake and Spider Bites.
think it is any good, please? B. W. WILLIAMS. DEAR DR. TAYLOR:—Please give us, thru The
Red Sulphur Springs, Tenn. WORLD, the latest treatments on snake and spider
(Croney's “specific for epilepsy” is sold on the bites, etc.
T. N. Roach, M.D.
mail-order plan by Dr. James T. Croney, of ColumBetty, Texas.
bus, Ohio. *Examination in the A. M. A. chemical (The bites of venomous reptiles are best treated
laboratory showed it to be a solution containing by free incision as quickly as possible, followed by
ammonium bromid and potassium bromid, as cupping or mouth suction. Later application of
essential constituents, containing bromid equivalent a strong solution of potassium permanganate or
to 16.9 grains potassium bromid per dose of two echinacea. Echinacea is given internally by many.
teaspoonfuls (two fluidrams). Like other epilepsy Supportive measures are indicated if there is
“cures," Croney's “specific for epilepsy" is merely
a bromid mixture and is both worthless and danevidence of absorption of poison. Insect bites may be treated in like manner,
gerous. (Journal A. M. A., April 17, 1915, p. 1344). but without incision. -ED.)
Gowan's Pneumonia Cure.
EDITOR MEDICAL WORLD:--Please give formula EDITOR MEDICAL WORLD:-Could you give me
of Gowan's treatment of pneumonia. some help on a case of ulcerative stomatitis? Eaton, Ohio.
C. W. CONLEY, M.D. Patient, young lady of 20. General health good. (According to“Nostrums and Quackery," Gowan's Menstruation regular, but scanty; flows two days pneumonia
consists of lard, camphor, and dark color. Constipated. Ulcers appear very turpentine, carbolic acid, opium, stearin, quinin small at first, but slowly increase and often persist and quinin sulfate. The proprietors of this nostrum for three or four weeks. Have tried most of the were convicted and fined under the Food and Drugs usual remedies, but seem to do very little, if any, Act for misbranding their product.–Ed.)
Mayr's “Wonderful" Stomach Remedy. them materially in some cases. This is a matter
EDITOR MEDICAL WORLD:- Please tell me what more of experience than anything else; it is difyou think of the inclosed pamphlet.
ficult to give even general directions, but it mar Niongua, Mo. Dr. W. F. Schlicht.
be taken as a general rule that in all abdomina. [The literature referred to Mayr's “Wonderful"
cases the amount of arsenic should be lessenec
and in uterin ones increased. stomach remedy, which will be found described
The dose varies also. Some patients appear in February World, 1914, pages 74 and 75.-Ed.)
to do well with 5 c. c. of the emulsion give
every second day or even every day, while i Pellagra.-Baughn's Remedy.
seems to be advisable with others not to give EDITOR MEDICAL WORLD:-We are having a more than 2 or 3 c. c. This is also very much scourge of pellagra in this country, some whites, a matter of experience. One indication of the but principally among the negroes. Patients strength of the dose is to be found in the impoorly nourished, diet principally corn bread and mediate effect of the injection. If the patient cotton seed oil. Please give me your best treat- feels sick at once, it is probable that the dose is ment, diet list, etc. What about Baughn's pellagra too large, and we are accustomed to reduce it to remedy, of Jasper, Ala?
the point which will avoid this feeling of nausea. Ringgold, La. J. A. MAUGHAM, M.D. Sooner or later a more or less strong odor of
(Baughn's pellagra remedy was described in these garlic will be noticed in the breath; in some, it columns in June, 1914, WORLD, pages 254–255. is very noticeable, and as a rule the odor does We have printed a number of articles on the subject not appear in the early stages of the treatment, of treatment of pellagra. Read them all.-ED.) and only when the disease has begun to improve
We hoped that some indication would be obtained
from this sign; for if the injection is used in a CURRENT MEDICAL THOUGHT. non-malignant case, the odor is strongly notice
able after the first injection. This we discovered
in the experiments on ourselves. Like everything Relief of Pain and Possible Cure of Cancer.
else connected with the disease, the appearance This is the title of a book by Skene Keith and of the odor is not to be depended on, as occaGeorge E. Keith, English practicians, and pub- sionally, tho rarely, it appears at the beginning lisht by the Macmillan Company, of New York. of the treatment of a case of undoubted cancer. We have referred to it in our columns before this, With the exception of the feeling of nausea if but, on account of various queries from various the dose is too large, and the odor of garlic in the subscribers, again mention the matter. The breath, the injections should not have any disauthors themselves are not radical or unreason- agreeable effects. able in claiming a "cure"; but they are reasonable Any serum syringe can be used. We have and rational in setting forth fully the results they found Record's as convenient as the all glass, and have obtained, and the possibilities of the treat- while it can be kept clean as easily, it is not nearly ment if further developed. To quote their at- so liable to break, and this is a consideration in titude thruout the book, we cite the following: several ways. Another objection to the glass is “The disease itself varies in such an extraordinary that spicules of glass are apt to crack off from manner that it does not seem to us probable that the end of the piston, and, passing in with the one line of treatment will ever be discovered that injection, set up irritation and lead to the formawill make a permanent cure in every case. We tion of an abscess. The needle should be kept doubt if any doctor has ever seen two cases run very sharp, as it makes a great difference to the an identical course.
patient; it should also be put in quickly. It may The following is a description of the method
seem unnecessary to go into such trifles, but it advised by the authors:
is really wonderful what a fuss can be made Exact directions for making the injections from a little matter like this of an injection. the separate ingredients with what we considered
When they are being repeated often, little details a standard dose. This strong standard injection are worth attending to. consisted of a solution of iodipin in oil, arseniate Thoro bathing with very hot water after an of iron, cacodylate of iron and cinnamate of injection helps to prevent bruising and keeps sodium. The iodipin is a 25% solution in oil. the parts soft; or a good liniment may be rubbed The arseniate of iron contains 14 grain of iron in. The injections are to be made subcutaneously, and 1/45 grain of arsenous anhydrid in 1 c c. not into the muscle, as with the arseniate of iron (15 minims). The cinnamate of sodium is a alone. The most convenient place, as a rule, is saturated solution containing 1/2 grains to the the outer part of the upper arm; next in order cubic centimeter. The emulsion which is formed come the buttocks, abdominal wall, and outer is a mechanical mixture and is not a new com- parts of the thighs. But the best plan is to try pound.
to find the part which gives the least trouble. The average proportions of the emulsion which we have used most are as follows: One dram of the iodipin and 20 minims each of the other three.
X-Ray Treatment of Cancer. If the mixture is made by shaking by hand, it In a “Textbook of Radiology" Dr. E. R. Moris advisable to thoroly shake together the iodipin
ton* says that as to the x-ray treatment of carciand cacodylate first, then add the cinnamate of noma it cannot be too strongly insisted upon that sodium and finally the arseniate of iron. The every operable case should be operated upon at the reason for mixing in this order is simply that
earliest possible moment. As soon afterward as it saves a great deal of shaking. If the mixing practicable thoro x-ray treatment of the whole is done by machinery, all the ingredients can be
area should be started and twelve doses given as put in together. These proportions may be taken Publisht by E. B. Treat & Co., New York, N. Y., as a standard, but we are accustomed to vary 1915. Price, $3.
follows: The tube should be from 9 to 10 Wehnelt, and a filter of 1 mm. of aluminum interposed; 0.75 of a pastille dose is given twice weekly up to a maximum of twelve doses, or until a slight degree of hyperemia shows itself. The skin may become "tanned” (see our editorial on “Actinotherapy,” in June WORLD, page 206), but at the first sign of reaction the treatment must be stopped for a week or two. If the condition of the patient and other circumstances permit there is no reason to delay the commencement of the treatment more than two or three days after the operation, and in treating cases of this kind we should not attempt to confine the rays accurately to the site of the operation, but allow as much as possible of the surrounding area to come under the influence of the irradiation.
After three months' interval, if all goes well, a further six applications are to be given, and again after a six months' interval.
If this procedure were carried out for two years in all cases, we should hear less of recurrences.
The great trouble is that post-operative treatment is not begun soon enough in a large proportion of cases, and in many of them deep extension has commenced, making all efforts to prolong life practically futile. There is not the least doubt that immediate post-operative X-ray treatment in carcinoma cases does definitely increase the patient's chance of making a complete recovery, and delay in applying this method not infrequently means that we are throwing away a victim's one chance of escape.
In no class of case is it more difficult to lay down definite rules for treatment; every case must be dealt with according to the conditions present. In most instances, the treatment will be more vigorous than stated above.
Full or even double pastille doses three times a week may be necessary for a time so as to produce a profound impression on the growth more or less quickly. If there seems to be deep extension, this is all the ore necessary, but here we must use a thicker filter-say 2 mm. of aluminum. The risk of dermatitis is very small when using such thick filter, but as we are giving massive doses we must act with all caution and discretion. On the other hand, only massive doses will be of any avail in a serious case, and we have to remember that if let alone the patient's life comes to an end in a short time; so that while we must not do anything to add to his sufferings thru X-ray dermatitis, we are justified in doing anything short of this that gives him a chance of escape or an extension of comparatively comfortable existence.
large indifferent negative electrode. A general anesthetic is required. There is coagulation necrosis or acid necrosis of the tissues for almost 1/2 inch around each metal point connected with the positive pole, and the portion of tissue thus destroyed dries up, and, eventually, after one or more weeks, separates, leaving a granulating surface.
Correct technic is extremely important. The indifferent negative electrode had better be a pad of kaolin laid over a smaller sheet of metal, which it more than covers. Any small area of metallic contact or markedly greater conductivity would permit a more concentrated Aow of the current, and produce, at the indifferent electrode, a negative burn, which is characterized by alkali necrosis or colliquative necrosis-a moist gangrenous process like that produced by the action of a caustic alkali. The patient is under the influence of an anesthetic, and so cannot give warning of the occurrence of a burn. The positive wire may be divided into about five strands, and it is best for the zinc points (pieces of sheet zinc, such as signs are painted on, about 14 of an inch wide at the base, about 3 inches long, and tapering to a very sharp point) to be soldered to the copper wires. If this is inconvenient, they may be bent around the wire and securely pinched. The points are galvanized by dipping them first in dilute acid and then in metallic mercury. The first point should be introduced before the current is turned on, and a rheostat should be used to very gradually increase the strength of the current from zero to 30 or 40 ma. Then another point is gradually introduced, and it will be found that the milliampere-meter registers an increased current, due to the larger area of contact. Other points are introduced so as to transfix the tissues all around, and, if practicable, beneath the growth. The current may then be found to be 50 or 60 ma., the increased area of contact at the metal points having greatly reduced the resistance at the positive pole, while the resistance at the negative pole has not been changed. Additional current is now turned on very gradually until 100 or even 200 ma. are indicated by the milliamperemeter. The flesh is seen to turn white, and a white froth exudes from the different punctures. The exact length of time that the current should be allowed to flow varies with the amount of tissue that is to be destroyed. It is usually between five and ten minutes. The current must be turned off just as gradually as it has been turned on, and the last metal point must not be removed until the current has ceased to flow. The 110-volt direct current is most suitable for the work. This may be obtained from the direct 110 volt electric light circuit, or from the alternating electric light circuit, by a rotary transformer, or a storage battery or a galvanic battery of the necessary number of cells to produce about 110 volts may be used.
This treatment has been applied to cancers of the breast and tongue, localities where turning the current on or off suddenly would cause serious shocks.
The advantages of this treatment are the freedom from hemorrhage, the complete destruction of the part to which it is applied, the presence of a sterilized and usually dry slough, which changes to a dry scab and comes away by natural processes. The disadvantages are that it does
Mercuric Cataphoresis in Treatment of
Cancer. The following description of the technic is taken from “Medical Electricity and Roentgen Rays,” by Dr. Sinclair Tousey* :
The term is usually applied to the method introduced by Massey. Extremely heavy currents of about 100 ma. or more are applied from the active positive electrode, consisting of sharp pieces of zinc amalgamated with mercury, thrust into the tissues while the patient lies upon a
*Second edition, publisht by W. R. Saunders Company, Philadelphia, Pa., 1915.
Price, $7.50, net.
not have a selective action upon the morbid tissue, nor one extending beyond the area actually destroyed, and that its cicatrizes are very bad compared with those left after a case has been cured by the x-ray or by surgical removal and a plastic operation.
While the method is certainly a valuable one for use in occasional special cases, it may not be unfair to characterize it in some other cases as an imperfect form of surgery. There is a ques. tion as to whether the destructive effect is at all due to the transportation of mercury into the tissues, or whether it is due altogether to the action of the electric current. The author feels that the latter is the chief factor in the case.
Books on Cancer. The following books, bearing directly upon the principal subject treated on in this issue, will be of interest to those who wish to equip themselves with literature on this vitally important disease:
“The Conquest of Cancer,” Saleeby. Publisht by F. A. Stokes Company, New York, N. Y. $1.75, net; postage, 18 cents. 361 pages. 1907.
“Cancer-Relief of Pain and Possible Cure," Skene Keith and George E. Keith. Publisht by the Macmillan Company, New York, N. Y. $1.25. 155 pages. 1908.
"Medical Electricity and Roentgen Rays," Tousey. Second edition, publisht by W. B. Saunders Company, Philadelphia, Pa. $7.50. 1,165 pages. 1915.
"A Textbook of Radiology," Morton. E. B. Treat & Co., New York, N. Y. 1915. $3. 217 pages. "Medical and Surgical Electricity," Rockwell
. E. B. Treat & Co., New York, N. Y. 1907. $5.
"Therapeutic Action of Light,” C. E. Rodgers, Chicago, Ill. 1910. $3.50. 318 pages. Publisht by the author.
"Radium and Cancer,” Wickham and Degrais. Publisht by Paul B. Hoeber, New York, N. Y. 1913. $1.25, net. 111 pages.
Chronic Gastritis: For years I have prescribed berberin, with nux, xanthoxylum or capsicum, iron carbonate if anemic.-ELLINGWOOD.
In typhoid fever the life-saving power of rhus above all other remedies is many times made manifest.-N. M. DEWEES, Ellingwood's.
When quinin fails to relieve malaria it is because it is not properly given, not absorbed, not continued long enuf, or we have failed to correct something that arrests the action of this greatest of specifics.-J. H. McCURRY, Ellingwood's.
Disease of the heart in children is much more amenable to treatment than in adults. Recovery in the early stages may always be counted upon with proper treatment.--Ellingwood's.
I failed in earlier experience to realize the importance of closed fractures with swelling of the leg even where the main artery was not completely severed.-C. H. LEMON, Wis. Med. Jour.
It is possible in simple leg fracture to have in 48 hours thru hematogenous infection a moist gangrene which with delayed amputation will invariably end in death.—LEMON, Wis. Med. Jour.
Chaney subjected many morphin habitués to immediate withdrawal and never saw dangerous symptoms develop, tho patients reach a very pitiable state.-Wis. Med. Jour.
When a patient emerges from the hyoscin treatment of morphin cure he is in an unfortunate condition and requires care for 4 to 8 weeks.-H. W. POWERS, Wis. Med. Jour.
There is no known malady that is not bettered by removing from its symptom-complex all that is due to fecal toxins in the blood.-Southern Practitioner.
By the time the Widal has satisfied us that we have to do with a typhoid fever all the practical result is to know what we might have done with benefit a week before.-Southern Practitioner.
To strap a swelled testicle use an inch-wide rubber bandage. Never apply adhesive plaster.
Orchitis subsides swiftly under applications of silver nitrate, 25 per cent.; but a cream of bismuth subnitrate and water does about as well and doesn't make the skin sore.
Extragenital syphilitic infections are exceedingly more common in physicians than in any other class of individuals.-HEIDINGSFELD, Am. Jour. Urol.
Oliver says eclampsia is twice more frequent than it was 25 years ago. This he attributes to the change in our foods that has reduced the content of mineral matter, especially phosphates and lime. Practitioner.
Scurvy and beriberi are deficiency diseases. Oliver suggests that not only eclampsia but appendicitis, duodenal ulcer and many others may be found in the same etiologic group.-Practitioner.
In a case of mental derangement due to high pressure Thomson had to give 180 drops of 10% aconite tincture with veratrum viride within 3 hours to get enuf relaxation.
Markt improvement followed.-Am. Jour. Med. Sci.
There is no source of knowledge to the doctor worth nearly as much as the study of the patient. All we get from general information is general.Southern Practitioner.
Gleanings from Current Literature. Which do you prefer-one idea in twenty pages, or twenty ideas in a single page?
Neural pangs subside under atropin or hyoscin. Acute myalgias respond promptly to ammonium chlorid in scruple doses every 8 hours. Many subacute pains fall before iodids. Rheumatic suffering is quelled by salicyl. Glonoin unlocks anginas; spasm relaxes under hyoscin.-Waugh, Southern Practitioner.
Wolbarst admits the value of the Wassermann test, but protests against the tendency to rely wholly on it to the neglect of clinical evidence. Am. Jour. Urol.
The development of an acute traumatic nephritis following a shock is incontestable. Manual exploration of the kidney may cause the appearance in the urin of all the elements found in this malady.-Pousson, Am. Jour. Urol.
Bovrie reports a case of unquestionable syphilis, treated with 606, which was followed by rapid development of general paresis.-Am. Jour. Urol.
Chronic Gastritis: The single remedy which has exercised the most direct influence in relief and cure is hydrastis canadensis.-ELLINGWOOD.
blindness; history of severe cold, many months, headache, dizziness, local tenderness, slight fever, possibly chills.—LEONARD, Med. Herald.
With 100,000,000 population we import 400,000 lbs. opium yearly; 90% used by habitués. Italy, with 30,000,000, uses 6,000 lbs.; Austria-Hungary, with 45,000,000, uses 3,000 yearly.-JEANNETTE Marks, Am. Jour. Pub. Health.
A number of physicians in reporting on lobelia have observed that patients who are addicted to drug habits find themselves relieved of the disease after they have taken a few hypodermics of lobelia.-Ellingwood's Therapeutist.
Avoid all criticism of colleagues in private conversation, and save critical energy for the medical society meeting.-ROBERT T. MORRIS, in Medical Council.
Some of the most obstinate cases of pruritus recti et ani, resisting all external applications, even painting with pure phenol and a 50% solution of silver nitrate, are at once relieved by a few properly performed prostatic massages. We have had several remarkable cases of this kind which we will report at a later date.-Critic and Guide.
It is so easy to shoot morphin in that it is apt to become a habit to pull out the hypo before the patient is thru the tale of woe.—Southern Practitioner.
The utero-ovarian sedatives are employed almost exclusively in shotgun prescriptions, and this has interfered with the scientific study of the single remedies.-Ellingwood's.
Clinical errors are due to ignorance, faulty judgment, obsession, failure to think anatomically (logically?), and reluctance to accept responsibility.-ABRAHAM.
A doctor, before a 40-mile ride, took a dose of macrotys; and the expected soreness did not materialize.-Ellingwood's.
However learned a man may be, he is not fully equipt as a practitioner until he is acquainted with the native plant remedies.-IRA WARREN.
Relief of any mechanical cause of constipation in an epileptic resulting in restoration of bowel function will temporarily cure the epilepsy.C. A. L. REED.
Kerr has a good word for chewing gum. It keeps the mouth clean and stimulates the flow of saliva; valuable in fevers.-N. Y. Med. Journal.
In 63% of gallstone cases there is a tender point over the interspace of the 9th, 10th or 11th ribs; and pressure on the end of the 11th rib will cause sharp pain.—BINET.
Tuberculosis: Of 373 cases, there were 142 positive X-ray diagnoses in which the sputum, if any, was negative. No case that could be classified as an early tuberculosis was found in which the X-ray report was negative.-GIFFIN AND SHELDON, Journal-Lancet.
If we are to develop a nation of physically sound men and women, more is necessary than action on the part of the public authorities.-L. K. FRANKEL, Am. Jour. Pub. Health.
Jeannette Marks says there are four million drug addicts in the United States. There is no village in which habitués cannot get from druggists all the opiates they want.--Am. Jour. Pub. Health.
Tenderness on percussion over the right kidney is especially valuable in differentiating between disease of the gall bladder, appendix and kidney; over the left, it distinguishes between kidney and pancreas disease.-MURPHY.
Disease is neither medical nor surgical, nor does it hover on the border lines; treatment has become more surgical, and the division is not scientific.-J. W. HEDDENS, Med. Herald.
There is a greater place for usefulness than ever before for the family practician, if he be at the same time a competent diagnostician.—HEDDENS, Med. Herald.
One of the most interesting and annoying things with which a surgeon has to deal is a fecal fistula. The attempt to effect a cure without opening the abdominal cavity as a rule will prove a failure.-T. E. POTTER, Medical Herald.
The Bulgarian bacillus is of benefit in cholecystitis, regulating the bowels and attenuating the action of the colon bacillus, and along with calomel in small doses followed by salines is the necessary treatment of the bowels.-CONRAD, Med. Herald
Sinus suppuration is accompanied by blurred vision, exophthalmos, divergent strabismus and
Kentucky, December 11-13, 1913. HYGIENE, MEDICAL JURISPRUDENCE, MENTAL AND
NERVOUS DISEASES. 1. Give period of incubation for scarlet fever, mumps, and measles.
2. (a) What is uncinariasis and (b) what is the prophylaxis ?
3. (a) What is meant by occupational diseases? (b) Name four of the most common kinds. (c) How may they be prevented ?
4. (a) Give the diagnosis and symptomatology of herpes zoster. (b) What are the characteristics of syphilitic eruptions of the skin?
5. Under wbat conditions is the induction of an abortion legally justifiable?
6. (a) Define a poison and (b) name five of the most common ones.
7. (a) How would you diagnose an impacted stone in the right ureter and (b) from what other conditions is it to be differentiated?
8. What is the clinical significance of acetone and diacetic acid in the urin ?
9. What is meant by (a) Babinski's sign, (b) Stell. wag's sign, (c) Kernig's sign?
10. Give differential diagnosis of tuberculous meningitis.
Answer8. 1. Incubation period of scarlet fever is about one day to three weeks ; of mumps is about two to three weeks ; of measles is about ten to twelve days.
2. Uncinariasis is hookworm disease, due to ingestion of the eggs of the hookworm. Propbylaxis consists in the use of proper toilet facilities and the wearing of sboes ; flies should be excluded.
3. An occupation-disease is a disease which is directly traceable to the effects of a particular trade in which a person is engaged. Caisson disease, writer's cramp, miner's nystagmus, and plumbism are occupational diseases. They can be prevented by a careful study of the etiological factors in each case, followed by removal or lessening, of the harmful features.
4. Herpes zoster is characterized by the formation of groups of vesicles along the line of a cutaneous nerve (such as an intercostal nerve), and accompanied by neuralgic pains. The disease is self-limited, is generally unilateral, and seldom recurs.
Syphilitio eruptions of the skin аге generally roughly symmetric, ham-colored, do not itch, may assume several different forms, and are more or less grouped.
5. Conditions that justify the induction of premature labor : (1) Certain pelvic deformities ; (2) placenta previa ; (3) pernicious anemia ; (4) toxemia of pregnancy ; (5) habitual death of a' fetus toward the end of pregnancy: (6) hydatidiform mole; (7) habitually large fetal head.