H LIND, JOHN E., M.D., Government Hospital for the Insane, Washington, D. C. OSLER, SIR WILLIAM, BT., M.D., F.R.S., Regius Professor of Medicine in the OUTERBRIDGE, GEORGE W., M.D., Out-Patient Surgeon and Pathologist to the SKILLERN, P. G., JR., M.D., Philadelphia. WATSON, EDWARD WILLARD, M.D., Philadelphia. WILCOX, SIDNEY F., M.D., F.A.C.S., New York. WILSON, SAMUEL M., M.D., Philadelphia. CONTENTS OF VOLUME I REMARKS ON THE DIAGNOSIS OF POLYCYSTIC KIDNEY. BY SIR WILLIAM OSLER, BT., M.D., F.R.S..... EMETINE IN THE TREATMENT OF AMBIC DYSENTERY. BY WILLIAM AN INFORMAL CONSIDERATION OF THE CLINICAL VALUE OF GRAPHIC METHODS IN THE STUDY OF HEART-DISEASE. PAGE PRACTICE. By GEORGE B. BATTEN, M.D.... ROUTINE OF PRACTICAL VACCINE THERAPY. By DR. HORACE GREELEY 47 THERAPEUTIC VALUE OF DIRECT TRANSFUSION OF BLOOD IN DISEASES OF THE NEW-BORN. By VICTOR D. LESPINASSE, M.D..... 61 MASSAGE IN THE TREATMENT OF DISEASES OF THE BILE PAS- THE VALUE OF THE X-RAY EXAMINATION IN THE DIAGNOSIS OF GASTRIC CANCER. By JAMES T. CASE, M.D....... EPITHELIOMA: ITS EARLY DIAGNOSIS AND AN EXCELLENT METHOD OF TREATMENT. By WILLIAM H. BEST, M.D..... A REPORT OF TWO VISITS TO THE MEDICAL CLINIC OF PROF. THOMAS MCCRAE AT THE JEFFERSON MEDICAL COLLEGE HOSPITAL IN OCTOBER, 1914. By E. J. G. BEARDSLEY, M.D......... 102 THE EARLY DIAGNOSIS OF GENERAL PARESIS. By JOHN E. LIND, M.D. 115 THE HEART IN SYPHILIS. By HARLOW BROOKS, M.D...... CLINICAL SIGNIFICANCE OF VARIATIONS IN THE SYSTOLIC AND ABNORMAL CONDITIONS FOUND IN OPERATING FOR FIXATION OF MOVABLE KIDNEY. By SIDNEY F. WILCOX, M.D., F.A.C.S........ 189 THE HODGEN SUSPENSION PRINCIPLE IN THE TREATMENT OF FRACTURE OF THE FEMUR. BY WILLIAM BRADY, M.D. CHORIONEPITHELIOMA ASSOCIATED WITH SEVERE INTRAPERI- LIST OF ILLUSTRATIONS TO VOLUME I TO (TWENTY-FIFTH SERIES) Tintometer fields (Fig. 9) COLORED PLATES Anterior view of extirpated uterus and appendages (Fig. 1)............. PAGE 96 204 204 Microscopic drawing (lower power), showing active invasion of the uterine wall by syncytial masses and clumps of trophoblast cells (Fig. 3)....... 206 PLATES, CUTS AND DIAGRAMS Complete station after Hoffman (Fig. 1).. Normal electrocardiogram (Fig. 2)... Dr. Berkeley's polygraph, improved, with parts assembled (Fig. 3) Normal venous and arterial tracing, made with the author's polygraph (Fig. 5) Boy of 15 years. Well-compensated mitral regurgitation (Fig. 6)..... Youth of 22 years. Double mitral murmur, durations and cause not determinable; compensation good until subjective palpitation developed a few days ago (Fig. 7) Enormously fat man of 64 years. Advanced emphysema, great dyspnea, and complaint of intense pain over sternum (Fig. 8)..... Dr. P, 42 years old. Old valve lesions, arteriosclerosis and high tension (Fig. 9) .... Man, 43 years old. Systolic murmur. Slight left hypertrophy; attacks of pain much like angina (Fig. 10). Arterial tracing from a little girl of 10 (Fig. 11)... ..... Man, 28 years. Double mitral lesion of some years' standing. In the erect position his pulse is 150, and to the finger shows no perceptible irregularity (Fig. 12) ... Electrocardiogram, case of auricular fibrillation in a man of 45 years. Patient had a very large heart and multiple murmurs (Fig. 13). Man, 37 years old. Rheumatic lesion of many years' duration. Fibrillation, the tracings showing at intervals ventricular coupling, the second beat of each couple being very large on the venous line, and small or absent on the arterial (Fig. 14) .... 30 Man of 76. Block. Ventricles beating regularly, 24 to the minute (Fig. 15). 30 Woman, 42 years. Valvular disease, dilatation, general dropsy. Peculiar pulsation in left side of neck-twice for every apex beat (Fig. 16)...... 30 Ampulla of Vater and ducts (Fig. 1)... 67 viii LIST OF ILLUSTRATIONS TO VOLUME I Position of abdominal organs (Fig. 2) A normal stomach, patient prone, plate anterior (Fig. 1).... Carcinoma of the stomach, semi-diagrammatic. The filling defect due to the carcinoma on the greater curvature is sketched in (Fig. 2) ..... A large splenic notch, indicating enlargement of the spleen (Fig. 3) Filling defect on the greater curvature due to extraventricular pressure (Fig. 4) ...... Filling defect on the greater curvature due to carcinoma (Fig. 5). Filling defect in the lower part of the greater curvature due to a large tuberculous ulcer. It will be noted that the gas and bismuth-filled splenic flexure also distorts the stomach shadow high up on the greater curvature (Fig. 6) Diagrams illustrating the difference between the hour-glass of ulcer (a) and the hour-glass of carcinoma (b) (Fig. 7) ... Hour-glass stomach due to penetrating ulcer on the lesser curvature at point shown by arrow (Fig. 8)... Hour-glass stomach due to an annular carcinoma just above the middle of the stomach (Fig. 9)..... Hour-glass stomach due to carcinoma implanted upon the base of an old lesser curvature ulcer (Fig. 10). . . . . . 80 Infiltrating scirrhous carcinoma involving practically the whole stomach (Fig. 11) 80 Carcinoma high up on the lesser curvature near the cardia (Fig. 12). 80 81 81 Gall-stones. The first part of the duodenum is well filled out in its characteristic manner. A peristaltic wave is constricting the pars pylorica. Perhaps an inch and a half from the pylorus, between the peristaltic wave and the pylorus, the greater curvature is made irregular by adhesions to the gall-bladder. The outline of the stones shows faintly (Fig. 16).... 81 Case clinically diagnosed carcinoma which proved to be gall-stone. One laminated gall-stone shown just above the pyloric antrum (Fig. 17).... Röntgenogram made with the patient lying upon the right side, plate anteriorly, tube posteriorly. The pylorus is thus the most dependent part of the stomach, and small filling defects are better shown. This röntgenogram shows very well the nature of a carcinomatous filling defect (Fig. 18) ..... Extensive carcinoma on the greater curvature not involving the pylorus. Note the unusual filling of the duodenum and of the small intestine, owing to pyloric insufficiency (Fig. 19)....... Extensive carcinoma of the lesser curvature (Fig. 20)... A deformity of the stomach simulating carcinoma of the lesser curvature. In this case it is due to extraventricular (hepatic) pressure. Peristaltic waves shown at arrows (Fig. 21).... Extensive carcinoma of the greater curvature (Fig. 22) Infiltrating scirrhus of the stomach. General peritoneal carcinomatosis producing small intestine stasis (Fig. 23)... 82 |