Showing papers in "JAMA Internal Medicine in 1941"
TL;DR: A group of 122 cases of bacteremia in which the causative agent was Staphylococcus aureus are studied, especially interested in analyzing these cases in the light of experimental infections as they have been produced in animals by numerous investigators.
Abstract: Within recent years there has been an increasing interest in the various aspects of infections caused in both man and animals by Staphylococcus aureus. In order to gather more information concerning the factors that influence the course of these infections in man, we have studied a group of 122 cases of bacteremia in which the causative agent was Staph. aureus. We were especially interested in analyzing these cases in the light of experimental infections as they have been produced in animals by numerous investigators. ANALYSIS OF CASES The 122 cases were observed at the Boston City Hospital over a seven year period. In all cases, the patients had demonstrable bacteremia on one or more occasions and the clinical course was entirely consistent with a severe infection. In only 22 cases did the patients recover, a fatality rate of 81.97 per cent. Seasonal and Sex Incidence. —There was no peak of
202 citations
TL;DR: Studies on the response of the body to acute blood loss are of both theoretic and practical importance because hemorrhage is a serious complication in many medical and surgical conditions.
Abstract: Studies on the response of the body to acute blood loss are of both theoretic and practical importance because hemorrhage is a serious complication in many medical and surgical conditions. In man, controlled observations on the effect of hemorrhage on the circulation, the plasma volume, the protein concentration and the cell-plasma ratio are difficult to obtain because the immediate care of the patient requires the complete attention of the physician and because the amount of blood lost is not known. In addition, the underlying disease producing the hemorrhage may alter the response of the body. Although many investigators have studied the effect of acute blood loss on lower animals, few studies on human subjects have been made under controlled conditions. Keith1observed changes in hematocrit reading and blood volume as determined by the dye method after the removal of 800 cc. of blood from a normal man. He found
144 citations
TL;DR: In recent years there has been a growing appreciation of the fact that not only do patients recover from acute myocardial infarction but often they can return to a reasonably normal way of life for some years.
Abstract: In recent years there has been a growing appreciation of the fact that not only do patients recover from acute myocardial infarction but often they can return to a reasonably normal way of life for some years. In his report in 1912, Herrick 1 pointed out that myocardial infarction was not necessarily fatal. However, for the next fifteen years, emphasis was placed on the clinical and the electrocardiographic diagnosis of this disease, and not until recently was attention directed to the course of those patients who survived an acute episode. Interest was no doubt stimulated by isolated reports 2 of persons who lived long and active lives after recovering from an acute attack. In this connection, it is interesting to note that Ryle 3 inferred, from Sir Everard Home's accounts, that John Hunter lived for twenty years after a typical acute coronary occlusion. However, as Levine 4 and Levy 5
103 citations
TL;DR: In a group of subjects first described by Bradbury and Eggleston3 in a discussion of postural hypotension, these reactions failed to compensate for the pooling of blood and there was a striking fall in arterial pressure when the blood was pooled.
Abstract: Man would have syncope while standing upright if it were not for certain adaptive mechanisms which tend to maintain a constant cerebral blood flow. In the standing position the amount of blood present in the upper part of the body is decreased, first, because the vascular bed in the portion of the body below the heart is dilated by a high hydrostatic pressure1and, second, because the high capillary pressure causes an increased filtration of fluid from the blood stream and a decrease in plasma volume.2This decrease in blood volume in the upper part of the body is compensated for by vasoconstriction and by increase in heart rate. In a group of subjects first described by Bradbury and Eggleston3in a discussion of postural hypotension, these reactions failed to compensate for the pooling of blood and there was a striking fall in arterial pressure when the
100 citations
TL;DR: It is indicated that the vascular apparatus plays a basic role in the production of altered tissue reactivity in man and a number of arguments support this hypothesis.
Abstract: In the pathogenesis of bronchial asthma mediated by specific hypersensitiveness, hereditary predisposition, as well as the immunologic mechanism, frequently plays an important role. This is especially common among atopic patients. The immunologic mechanism is regarded as involving an antigen-antibody reaction on or within certain cells or tissues designated as shock organs. These organs are likewise usually subject to hereditary influences. The particular site of the allergic reaction, whether the epithelium, the smooth muscle or the endothelium of blood vessels, has been subject to a great deal of controversy. It is the purpose of this paper to review this phase of the problem and to indicate that the vascular apparatus plays a basic role in the production of altered tissue reactivity in man. A number of arguments support this hypothesis. According to Lewis 1 and Dale 2 the antigen-antibody interaction is supposed to result in the liberation of a histamine-like substance
95 citations
TL;DR: Opinions as to the presence and nature of cardiac lesions associated with chronic infectious (rheumatoid) arthritis have been varied.
Abstract: Opinions as to the presence and nature of cardiac lesions associated with chronic infectious (rheumatoid) arthritis have been varied. Fuller 1 and Garrod 2 have stated that, as a rule, the heart is not injured in rheumatoid arthritis. Fuller stated that he had never seen a case in which he could attribute pericarditis or endocarditis to rheumatoid arthritis. Garrod observed that if patients with rheumatoid arthritis have valvular insufficiency, one can assume a previous attack of rheumatic fever has been the cause of the lesion. Strumpell 3 and Pribram 4 stated that in rheumatoid arthritis of slow, insidious onset cardiac involvement does not occur, but when the disease is ushered in by an acute febrile attack of arthritis the heart is often implicated. Barjon, 5 on the other hand, estimated that the number of cardiac complications is just as high in the cases of rheumatoid arthritis with chronic onset as
90 citations
TL;DR: The clinical and diagnostic features of "pinealism" were described by Frankl-Hochwart who wrote: When one finds in a very young person (boy) along with the general symptoms of tumor, as well as the local signs of a lesion of the corpora quadrigemina, abnormal body growth, unusual growth of hair, adiposity, somnolence, premature genital and sexual development and, finally, intellectual maturity, one must think of a pineal body.
Abstract: Though numerous endocrine disturbances occur with disease or tumors of the brain, none has a more intriguing interest or presents so challenging a problem with respect to its cause than precocious puberty. There is at present a widely believed theory that it is caused in some way by tumors of, or in the region of, the pineal body. This association was first pointed out by Gutzeit, 1 but his case, viewed now, curiously does not appear to be a genuine instance of precocious puberty. The clinical and diagnostic features of "pinealism" were described by Frankl-Hochwart, 2 who wrote: When one finds in a very young person (boy) along with the general symptoms of tumor, as well as the local signs of a lesion of the corpora quadrigemina, abnormal body growth, unusual growth of hair, adiposity, somnolence, premature genital and sexual development and, finally, intellectual maturity, one must think of a
84 citations
TL;DR: Two families are observed in which, although bilirubinemia of the "indirect" type was present, there were the signs neither of hepatic disease nor of splenomegaly, increased fragility of the red cells or reticulocytosis, and final proof of the nonhemolytic character of the icterus was obtained from study of the urobilinogen content of the feces.
Abstract: Jaundice of the familial type is almost invariably considered to be hemolytic. Congenital or familial hemolytic (acholuric) icterus is a well defined disease entity. That there are instances of familial icterus in which all the evidences of excessive blood destruction are lacking has only occasionally been recognized. We have recently observed two families in which, although bilirubinemia of the "indirect" type was present, there were the signs neither of hepatic disease nor of splenomegaly, increased fragility of the red cells or reticulocytosis. The urine was free of bilirubin and did not contain increased quantities of urobilinogen, and the results of hematologic examinations were uniformly normal. Final proof of the nonhemolytic character of the icterus in these families was obtained from study of the urobilinogen content of the feces, which was either normal or slightly decreased. From 1900 to 1907, Gilbert and his associates 1 described a series of cases of
75 citations
TL;DR: The presence of diastase in human blood was first noted in 18462 and subsequently the enzyme was found to be a normal constituent of mammalian blood in general and its origin was traced to the blood.
Abstract: The presence of diastase1in human blood was first noted in 18462and subsequently the enzyme was found to be a normal constituent of mammalian blood in general. In 1863 the enzyme was shown to be present also in urine, and its origin was traced to the blood.3Eventually diastase was detected in lymph,4in pericardial fluid4band in feces.5Hepatic bile is almost completely devoid of diastase,6but the enzyme can be detected in the bile when the diastase content of blood is greatly increased by ligation of the pancreatic ducts.7Bile from the common bile duct and the gallbladder may contain appreciable amounts of diastase as the result of pancreatic reflux.8Assertions that measurable amounts of diastase are present in the cerebrospinal fluid,9the liver and the kidneys10are open to doubt. In this laboratory it was not possible to detect diastase in the
73 citations
TL;DR: The voluminous literature on venous thrombosis contains surprisingly little pertaining to the deep veins of the calf, and it appears to us that such factors as antagonism on the part of embalmers toward extensive dissection, restrictions imposed by relatives and ambiguity or possible interpretations of the laws pertaining to mutilation may be more potent reasons for the paucity of figures.
Abstract: Generally accepted facts are not invariably supported by published data. The voluminous literature on venous thrombosis contains surprisingly little pertaining to the deep veins of the calf. This is scarcely attributable to ignorance or to a lack of appreciation of phlebothrombosis in this part of the body. Experienced necroscopists have long been aware that the legs constitute a common, though often clinically silent, reservoir of clot formation during life and at autopsy seek here when other more readily accessible sources of embolism have failed. Rather, it appears to us that such factors as antagonism on the part of embalmers toward extensive dissection, restrictions imposed by relatives and ambiguity or possible interpretations of the laws pertaining to mutilation may be more potent reasons for the paucity of figures with respect to this part of the body. Much credit for the recognition of the common occurrence and the clinical importance of venous
70 citations
TL;DR: Functional differentiation may be assumed to have preceded anatomic alteration and reduction in the mammalian heart and in the avian heart, where the relatively small auriculoventricular conduction system furnishes the only morphologic connection between auricles and ventricles.
Abstract: As evolution proceeded, the muscular connection between auricles and ventricles gradually diminished. In the piscine heart, junctional fibers are present and conduct equally well in either direction at the whole circumference of the auriculoventricular border. In the amphibian heart, some parts of the junctional tissue conduct better than others; in some sections, reversed, or ventriculoauricular, conduction is even more rapid than normal, or auriculoventricular, conduction. Differences in conductivity are even more pronounced in the reptilian heart, and a reduction in the amount of conduction tissue has occurred. 1 Differentiation and specialization are still more evident in the avian heart, and in the mammalian heart the relatively small auriculoventricular conduction system furnishes the only morphologic connection between auricles and ventricles. Thus, functional differentiation may be assumed to have preceded anatomic alteration and reduction. A second communication between auricles and ventricles in man has been suggested as an atavistic, inherited anomaly occurring
TL;DR: This work has shown that in sudden death due to disease of the coronary arteries an acute occlusion frequently is not found, and that the two types of infarction differ sharply in their pathogenesis and in the pathologic changes they present.
Abstract: For some time a transitory insufficiency of the coronary blood flow has been accepted as the physiologic basis for the anginal syndrome. Only recently, 1 however, has it been sufficiently realized in this country that infarction of the myocardium may result from acute coronary insufficiency, in the absence of coronary occlusion or even of coronary sclerosis. The German literature 2 has emphasized the frequency of cardiac infarction due to coronary insufficiency. In two large series of cases of myocardial infarction studied post mortem, Graef 3 and Horn 4 found recent coronary occlusion in only 60 per cent, the remaining infarcts being associated with coronary insufficiency. Several authors 5 have stated that in sudden death due to disease of the coronary arteries an acute occlusion frequently is not found. These two types of infarction differ sharply in their pathogenesis and in the pathologic changes they present. Occlusion of a coronary artery
TL;DR: Torula infection is recognized as a rare disease caused by a yeastlike parasitic fungus belonging to the fungi imperfecti which seems to have a special predilection for the central nervous system and lungs.
Abstract: Torula infection is recognized as a rare disease caused by a yeastlike parasitic fungus belonging to the fungi imperfecti which seems to have a special predilection for the central nervous system and lungs. Cryptococcus hominis has recently come into rather general use as the name for the pathogenic organism of this disease. According to Freeman, 1 Zenker's report in 1861 of a case in which involvement of the central nervous system occurred probably represents the first description of torula infection in man. As early as 1901 Vuillemin 2 first used the term C. hominis for the yeastlike organism found in the lesions of European blastomycosis. Frothingham, 3 studying a tumor-like mass in the lung of a horse in 1902, discovered and described the yeastlike fungus causing the lesion. After cultural examinations and animal inoculations, he concluded the pulmonary lesion in the horse was caused by a torula. There seems little
TL;DR: This study was undertaken to establish the current leading impressions of the diagnostic criteria of the disease carcinoma of the pancreas, and to determine from a review of a series of proved cases which criteria should be followed.
Abstract: With progressive advance in surgical technic radical but curative operations have been made possible in cases of carcinoma of the pancreas. For these operations to be successfully employed, however, it is of utmost importance that an early diagnosis be made. Yet accuracy of diagnosis at any stage is not great, especially when there is no jaundice or when the body or tail of the pancreas is predominantly involved (table 1). In many cases the disease is incorrectly diagnosed and its presence is missed in the early stages because in the mind of the average physician certain impressions of traditional diagnostic criteria have persisted despite the fact that they have been repeatedly shown to be false. This study was undertaken to establish, first, the current leading impressions of the diagnostic criteria of the disease carcinoma of the pancreas, and second, to determine from a review of a series of proved cases
TL;DR: A recent survey of records of 3,300 consecutive autopsies at the Institute of Pathology of the University Hospitals of Cleveland revealed 18 cases of congenital bicuspid aortic valve, nine of which occurred among newborn and newborns.
Abstract: Congenital bicuspid aortic valves are of two types, those consisting of two normal cusps and those in which one of the two cusps is subdivided by a ridge of congenital origin into two segments. The first type is evidently due to improper development of the endocardial swellings in the truncus arteriosus that form the rudimentary cusps or possibly to faulty growth of the aortic septum which normally bisects the two lateral endocardial cushions. In the second type there is maldevelopment of a commissure due to arrested growth of the annulus fibrosus and of the projections of the annulus that normally form the commissural cusp margins. The congenital ridge thus represents an abortive and deformed commissure. A recent survey of records of 3,300 consecutive autopsies at the Institute of Pathology of the University Hospitals of Cleveland revealed 18 cases of congenital bicuspid aortic valve. Nine of these occurred among newborn and
TL;DR: During the summer of 1937 there came under observation at the New York City Hospital, Welfare Island, a case of intractable cardiac dysfunction, certain features presented by the patient suggested the presence of a malignant tumor of the heart.
Abstract: During the summer of 1937 there came under observation at the New York City Hospital, Welfare Island, a case of intractable cardiac dysfunction. Certain features presented by the patient suggested the presence of a malignant tumor of the heart. We were able to confirm the diagnosis later by autopsy. Search of the records in the pathologic laboratory revealed 3 other cases of cardiac disease due to neoplasm. These 4 cases form the basis of this report. REPORT OF CASES Case 1. —Lymphosarcoma of upper retroperitoneal and mediastinal lymph nodes, with metastases to heart, pleura, lungs, diaphragm, pancreas, thyroid and kidneys. A white married woman aged 17, seven months pregnant, was admitted to the obstetric division, service of Dr. K. Johnson, on May 11, 1937. The family history was essentially irrelevant. She had been born with forceps delivery and breast fed for three or four months. Until the age of 5
TL;DR: A search of the voluminous literature on coronary thrombosis and myocardial infarction has failed to reveal any publications dealing with this correlation between shock and multiple coronary occlusion, although the existence of multiple fresh thrombi has been noted by several observers.
Abstract: In a study of the clinical and pathologic findings in a series of 350 cases, we have observed multiple fresh coronary occlusions in a group of 11 cases. In 8 of these, multiple fresh thrombi had occluded the arteries; in the remaining 3 cases multiple occlusions were due to hemorrhages within the atheromatous plaque and to ruptured atheromatous abscesses. The hearts in these 11 cases were studied by the method of injection and dissection of the coronary arteries previously described. 1 The striking observation was made that all these instances of multiple fresh occlusions occurred in the presence of shock. A search of the voluminous literature on coronary thrombosis and myocardial infarction, as well as reference to the standard cardiologic texts, has failed to reveal any publications dealing with this correlation between shock and multiple coronary occlusion, although the existence of multiple fresh thrombi has been noted by several observers.
TL;DR: There are now on record some 20 cases fulfilling the requirements for inclusion within this restricted group, including the case herein presented, and the absence of all factors commonly believed to cause secondary pulmonary vascular sclerosis, pulmonary hypertension or isolated strain of the right side of the heart.
Abstract: Primary pulmonary vascular sclerosis in the restricted sense of the term defined by Brenner1is a rare condition. Up to 1935 Brenner collected from the literature only 15 cases, to which he added 1 of his own. This number, however, is probably incomplete; at least 1 other case should be included, the one reported by MacCallum.2 Since 1935 2 additional instances have been reported; including the case herein presented, there are now on record some 20 cases fulfilling the requirements for inclusion within this restricted group. These requirements are (1) the presence of significant hypertrophy of the right ventricle but not of the left and (2) the absence of all factors commonly believed to cause secondary pulmonary vascular sclerosis, pulmonary hypertension or isolated strain of the right side of the heart. REPORT OF A CASE A married woman aged 21 entered the Multnomah County Hospital Feb. 2, 1940
TL;DR: This study was made in an attempt to trace the natural development of bronchiectasis in a series of cases, finding much that was helpful, but also much that appeared to be contradictory and confusing.
Abstract: This study was made in an attempt to trace the natural development of bronchiectasis in a series of cases. An examination of the voluminous literature yielded much that was helpful, but also much that appeared to be contradictory and confusing. It was felt, therefore, that a fresh start must be made and any conclusions must be based on the continued observation of a number of actual cases. The literature was, therefore, referred to chiefly for the purpose of comparison and for amplification of those aspects which appeared to be inadequately covered by the evidence from the present series. The subject was a large one, and the method of its treatment was seriously considered. The disadvantages of employing the "textbook" method were realized, but were regarded as capable of exaggeration. No other means of approach can compare with it for comprehensiveness, clarity and ease of reference. The disease, therefore, was dealt
TL;DR: The incidence in 3 interrelated families of pure German extraction of 86 members with large numbers of such cells is described, which is the largest group for which this condition has been reported.
Abstract: In recent years attention has been directed to the fact that the red cells of an apparently healthy person are not necessarily round but may be distinctly elliptic or even sausage shaped. This condition has been recognized as a congenital anomaly, frequently called "ovalocytosis" in spite of the fact that the red cells are not strictly oval. This paper describes the incidence in 3 interrelated families of pure German extraction of 86 members with large numbers of such cells. This is the largest group for which this condition has been reported. In addition, we present features of the anomaly not previously recorded. REVIEW OF THE LITERATURE Because reports of this condition have appeared in many languages and are not universally accessible, it seems desirable to present here a fairly complete review of the literature. To Dresbach 1 goes the credit for reporting the first case of the anomaly. A mulatto
TL;DR: Data is included which demonstrates that aluminum hydroxide gel interferes with phosphate absorption and the results of the use of aluminum phosphate gel in the treatment of experimental and clinical peptic ulcer are presented.
Abstract: Our use of an aluminum phosphate gel in the therapy of peptic ulcer resulted from observations on the effect of aluminum hydroxide gel on the absorption of phosphates from the intestine. In a publication1on the effect of aluminum hydroxide gel on the well-being and longevity of Mann-Williamson dogs, Fauley, Ivy, Terry and Bradley suggested that the unfavorable effects of this chemical in such animals might be due to an interference with the absorption of phosphates. The present report (a) includes data which demonstrate that aluminum hydroxide gel interferes with phosphate absorption and (b) presents the results of the use of aluminum phosphate gel in the treatment of experimental and clinical peptic ulcer. Experimental ulcers were produced in Mann-Williamson dogs. The preparation of such an animal includes performing a gastrojejunostomy and diverting the pancreatic juice and bile into the terminal portion of the ileum (last 20 to 25 cm.).
TL;DR: The patients whose cases are included in this study were admitted between 1933 and 1938 to the Jewish Hospital, a general hospital for patients with acute conditions, excluding contagious and mental diseases.
Abstract: In another report from this laboratory 1 the normal range of diastatic activity of the blood was established, based on determinations by the analytic technic of Somogyi. 2 It was shown that this range lies between 80 and 150 and that the ranges between 60 and 80 and between 150 and 180 are on the borderline of normal. Diastase values below 60 and above 200 are considered definitely abnormal. The present report is concerned with pathologic conditions which in general are associated with abnormal increases in the level of the blood diastase. Those associated with subnormal levels were discussed in a separate report. 3 The patients whose cases are included in this study were admitted between 1933 and 1938 to the Jewish Hospital, a general hospital for patients with acute conditions, excluding contagious and mental diseases. Since only one determination was made in the majority of cases, we have disregarded
TL;DR: The vitamin A content of the liver has been reported by several observers, but as a variety of methods were used for the determination of vitamin A and as many of these methods have since been shown to have a wide margin of error, the majority of the results are qualitative rather than quantitative.
Abstract: The vitamin A content of the liver has been reported by several observers, 1 but as a variety of methods were used for the determination of vitamin A and as many of these methods have since been shown to have a wide margin of error, the majority of the results are qualitative rather than quantitative. An exception to this is the report by Crimm and Short, 2 in which the livers of 7 healthy persons were found to have an average vitamin A content of 33,100 U. S. P. units per hundred grams of liver. In a later study 3 they reported that in 50 patients with tuberculosis the average vitamin A content of the liver was 34,200 U. S. P. XI units per hundred grams. In 14 of the patients, however, the vitamin A content of the liver was low. Occasional scattered reports of both the vitamin A and
TL;DR: Analysis of the considerable material that has been accumulated supports the early interpretation of the decrease in blood diastase associated with impaired hepatic function, but is unable as yet to offer any valid explanation.
Abstract: In other communications from this laboratory the normal diastase values 1 and the significance of elevated blood diastase 2 were discussed. The accurate assay of subnormal amounts of diastase afforded by the Somogyi technic 3 revealed that subnormal diastase values were far more frequent than were increased values. In preliminary reports 4 it was pointed out that low blood diastase values seemed to be indicative of impaired hepatic function. Analysis of the considerable material that we have accumulated, which forms the basis of this study, supports this early interpretation. Other investigators using the Somogyi technic have corroborated this concept. 5 We are unable as yet to offer any valid explanation of the decrease in blood diastase associated with impaired hepatic function. If diastase were found in the liver, one could assume that the production of the enzyme is one of the functions impaired when the liver is affected. But, as
TL;DR: It is surprising to find that no one has catalogued the symptoms as they have been described in the reports of cases which have been published, and there has been a tendency to use the "classic" case as the basis for endocrine hypotheses and implications which are not limited to this particular subject, but which bear on other current endocrine problems as well.
Abstract: Adrenal cortical tumors and allied disturbances1continue to arouse considerable interest. Since the last review of the subject appeared in this journal2a considerable number of cases have been reported and several comprehensive articles dealing with these conditions have appeared.3 TUMORS OF THE ADRENAL CORTEX It is surprising, however, to find that no one has catalogued the symptoms as they have been described in the reports of cases which have been published. We have felt for a long time that some such work should be undertaken, because the various individual cases do not always conform, by any means, to the composite picture which has been so frequently described. Furthermore, there has been a tendency to use the "classic" case as the basis for endocrine hypotheses and implications which are not limited to this particular subject, but which bear on other current endocrinologic problems as well. With these
TL;DR: A review of the literature reveals a sparsity of observations on the electrocardiographic alterations induced by the flaccid paralysis, and it is the intention in this report to furnish additional data along these lines, as well as experimental observations onThe effects of certain drugs.
Abstract: Study of this rare disease has recently been stimulated by the discovery that the recurrent attacks of flaccid paralysis which characterize this condition are associated with a marked fall in the serum potassium and that the administration of potassium salts brings about rapid recovery from the attacks. 1 A review of the literature reveals a sparsity of observations on the electrocardiographic alterations induced by the disease. The papers of Janota and Weber 2 and Zabriskie and Frantz 3 are the only ones, to our knowledge, which record electrocardiographic observations. These authors found lowering of the T waves during the paralytic episodes. It is our intention in this report to furnish additional data along these lines, as well as experimental observations on the effects of certain drugs. REPORT OF CASE B. R., a man aged 25, came under our observation in February 1939. His family history was unknown to him in
TL;DR: It is hoped that a review of this case and a resume of the literature may help to direct the attention of physicians to this disease when they are dealing with conditions having similar symptomatology.
Abstract: The symptom complex of bronchiolitis fibrosa obliterans, although fairly well defined, is one which usually escapes clinical recognition. This disease results from organization of fibrinous exudate in the bronchioles in response to local injury. The total number of cases reported is small, and only 1 has been discovered among the 42,038 autopsies performed by members of the pathology department at the University of Minnesota Medical School since 1899. In this case the patient was studied clinically at the Minneapolis General Hospital, and I followed closely the course of his disease. It is hoped that a review of this case and a resume of the literature may help to direct the attention of physicians to this disease when they are dealing with conditions having similar symptomatology. Bronchiolitis fibrosa obliterans was first described and recognized as a pathologic entity in 1901 by Lange, 1 who differentiated between it and other processes which
TL;DR: The relation of a hyperactive reflex to some of the unconscious and convulsive states in man is shown and the normal carotid sinus mechanism with its various reflex responses is considered.
Abstract: Within the past few years, since the publication of the comprehensive experimental work on the carotid sinus reflex by Hering1and Heymans,2there has been some application of the knowledge regarding this reflex to clinical medicine. The most important contributions are those of Weiss and Baker,3Ferris, Capps and Weiss4and Weiss, Capps and Ferris.5They showed the relation of a hyperactive reflex to some of the unconscious and convulsive states in man. That unconsciousness and convulsions might be induced in some persons by pressing on a carotid artery at its bifurcation has been known for hundreds of years. Ask-Upmark6stated that the Assyrians used this method to dull pain during the rites of circumcision. The mechanism of its production, however, was not known until of late. Before the hyperactive cardioinhibitory carotid sinus reflex is considered, the normal carotid sinus mechanism with its various reflex responses
TL;DR: Hereditary ectodermal dysplasia is apparently the first report of the affliction occurring in three members of one family in the same generation, with the exception of the family described by Darwin.
Abstract: Studies are reported on 3 patients with hereditary ectodermal dysplasia. With the exception of the family described by Darwin, 1 this is apparently the first report of the affliction occurring in three members of one family in the same generation. Special studies on these persons include serum analyses and observations on the effect of exposure to high environmental temperatures. The literature pertaining to hereditary ectodermal dysplasia has been reviewed by MacKee and Andrews, 2 Weech, 3 Gordon and Jamieson, 4 Lord and Wolfe, 5 de Silva 6 and others. In 1929 Weech listed 10 cases of this unusual condition; in 1931 Gordon and Jamieson listed 21 cases, and more recently, in 1938, Lord and Wolfe tabulated in chronologic order more than 40 cases described in the literature together with a bibliography pertaining to them. The salient features of the disease are: the absence of sweat glands and occasionally of lacrimal glands; the growth of
TL;DR: Coccidioidal cavitation, as demonstrated in the 13 cases reported in this paper, is far more benign than is pulmonary cavitation due to tuberculosis, which develops during or shortly after the primary stage of pulmonary infection.
Abstract: That the roentgenographic appearance of pulmonary coccidioidal infection may closely simulate that of pulmonary tuberculosis has been pointed out repeatedly, particularly by Smith, 1 Yegian and Kegel 2 and Farness and Mills. 3 When pulmonary cavitation occurs the mimicry is even more striking, and confusion in diagnosis may follow unless the causative organism is first isolated and identified. It would appear, however, that such parallelism between the two infections exists only in roentgenograms. Coccidioidal cavitation, as demonstrated in the 13 cases reported in this paper, is far more benign than is pulmonary cavitation due to tuberculosis. Unlike the latter condition, which usually occurs during reinfection or in the adult type of the disease, most coccidioidal cavitation develops during or shortly after the primary stage of pulmonary infection. This belief was also expressed by Farness and Mills in their first report of a case of pulmonary cavitation due to coccidioidal infection.