Pound Of Weight Research Articles

The coexistence of carcinoma and tuberculosis of the uterus

Mrs. 8. M., a Syrian-Jewish married woman of 46 pwrs, W:W :ululitted to tlte Israel Zion Hospital on Feb. 24, 1938, with the chief complaint of vaginal bleeding. Family history and past history were irrelevant. She was gravida iv and para i. A son, aged 33 years, was in good health. The menstrual cycle was 14 x 30 x 6, with menopause at the age of 40. For four weeks before admission she had a profuse painless vaginal bleeding. She lost 14 pounds in weight within one year. Physical findings were essentially negative. She was fairly well nourished. Heart and lungs were negative. Uterus was soft, boggy, and retroverted. Cervix was eroded. Blood examination showed erythrocptes 4,000,600, leucocytes 8,000 per c.mm. with a normal differential. a preoperative diagnosis of retroversion, cervical polyp, and fibroid uterus was made. On Feb. 25, 1938 a total hysterectomy was done, leaving both adnexa which appeared normal. When tension sutures were introduced in the uterus during the operation, pus escaped along the suture lines. This was interpreted as being due to pyometra. The postoperative course was uneventful, and pat,ient w-as discharged twenty-two days later. When seen, twenty-two months after the operation, the patient was apparently in good health. She had gained 20 pounds in weight and, as far as could be determined, she had no symptoms or signs referable to the lungs or pelvic organs. A roentgenologic examination of her lungs was essentially negative. She has also been followed up at the Memorial Hospital of Xew York, where no treatment was given her, as “at no time was any lesion found after the operation.” Pathologic Findings.-Gloss Appearance of Uterus: Uterus was rather small, weighing 60 Gm. and measuring 70 mm. in length, from 25 to 30 mm. in width, and from 20 to 30 mm. in thickness. The fundus was rounded, globular, and fluctuant. On the posterior aspect in the midline, 2 cm. distal to the fundic rim, a subserous, pea-sized, calcified yellowish nodule was seen. On inserting a fine probe within the cervical cavity, the latter was found to end blindly at the internal OS and no continuity between it and the uterine cavity could be established, except by a forceful thrust of the probe. The cervical canal was narrow, but free from exudate. The cavity was filled with a thick, stringy yellowish white purulent matter. The entire endometrium from the fnndus and to the internal OS presented a ragged, cupped out, honeycombed appearance (Fig. 1). On closer inspection, numerous pin-point-sized, yellowish tubercles could be seen scattered throughout the endometria.1 surface. The mgometrium was thin, averaging 15 mm. in width. The nleeration ceased abruptly at the internal OS. Cervix : Portio vaginalis was smooth, pinkish, and glistening. At its junction with the cervical canal, there was a snrall, fairly circumscribed nodule, 8 mm. in tliameter, which was slightly raised and its upper surface somewhat roughened (Fig. 1). On section, it showed slight thickening of the lining epithelium. &‘~croscopic F&n-Zings.--Section of the cervix, in the region of the grossly observed nodule, showed the surface to be mostly ulcerated and only partly lined by considerably hyperplastic epithelium which passed abruptly into a diffusely growing tumor (Fig. 2). This consisted mainly of masses of polyhedral or spindle-

Thyroid therapy in juvenile myxedema

L. G. ROWNTREE, M.D. PHILADELPHIA, PA. p ROBABLY no ordinary glandular deficiency is more frequently overlooked than myxedema, especially in its juvenile form. This is unfortunate, because nothing in therapy succeeds much more brilliantly than does thyroid medication in juvenile myxedema. Since the recognition of the role of the growth hormone of the pituitary gland, a tendency has arisen to regard an element of pituitary deficiency as universally present in all cases of infantilism. \Vith this idea in mind, it has become the custom with many physicians to treat these cases of dwarfism with a mixture of hormones in which the pituitary products are employed generously, but in which the thyroid medication is given only in small and inadequate amounts. However, in juvenile myxedema the deficiency is one of the thyroid .alone, and thyroid medication only is indicated. Pituitary products are not usually necessary. In fact, their addition may befog the issue at times and lead to ineffective management unless the amount of thyroid is kept sufficient. However, if true indication for pituitary products exists, obviously they should be employed, but not at the expense of thyroid therapy. Two patients in point are presented, both of whom, in my opinion, were suffering from juvenile myxedema. In infancy both were regarded correctly as eases of hypothyroidism. Later both patients were placed in the hands of specialists who looked upon them as instances of primary pituitary deficiencies and who placed them on mixed pituitary and thyroid products. On this management neither patient made satisfactory response, but both have experienced phenomenal growth and normal development when given adequate thyroid therapy alone, or mixed treatment in which the thyroid has been maintained at an adequate level. The first case concerns a dwarfed child who was brought to me at 7 years of age. In the seven months prior to seeing me, she had made practically no growth. Solely on thyroid therapy in adequate amounts, she has grown 20 inches in height and has gained 57 pounds in weight during six and one-half years (Fig. :1). The second case is in some ways still more remarkable, in that growth has been accomplished still more rapidly and at an older age. I t concerns a fat, dwarfed child, 15 years of age, who gained but onequar ter of an inch in one year on a mixture of products administered

Regression of Pulmonary Metastases from Mammary Carcinoma Following Inactivation of Ovaries by Irradiation

It has been well established that certain mammary carcinomas recede definitely following the withdrawal of ovarian hormonal stimulation. Beatson (2), in 1896, reported shrinkage of primary tumors, regression of metastases, and improvement in the general condition of patients following oophorectomy. Wintz (8) appears to have first used roentgen castration as an adjuvant in the treatment of carcinoma of the breast. Ahlbom (1) reported the treatment of 163 cases with rather indeterminate results. Martin (4), Dresser (3), Smith (5), and Taylor (6) have reported regression of metastases in bone following roentgen castration and have given excellent reviews of the literature. Dresser observed regression of skeletal metastases in 30 per cent of cases, clinical improvement without evident regression in 43.3 per cent, and no response in 26.6 per cent of a total of 30 cases under 45 years of age. Pulmonary metastases from carcinoma of the breast present a dismal and distressing picture. The progressive, intractable symptoms of cough, pain, and dyspnea harass the patient and confound the physician. Treves (7) has recently shown that administration of radiotherapy to the lungs is deleterious rather than beneficial to the patient. Dresser (3) reported regression of pulmonary metastases in one case following 600 roentgens to the pelvis through anterior and posterior ports. We have observed striking and unexpected regression of pulmonary metastases with relief of symptoms in two cases following inactivation of ovaries by irradiation. Case Reports Case 1. V. S. Nebraska Methodist Hospital. Referred by C. R. Kennedy, M.D., on Feb. 3, 1933. Housewife, aged 35. A radical mastectomy had been done five years previously for a Grade III adenocarcinoma of the right breast. She entered the hospital with a history of gradually increasing unproductive cough, pain in the back, failing vision, and loss of 30 pounds in weight during four months. Examination showed numerous hard lymph nodes in the left axilla and dullness over the right chest. She was unable to count fingers at two feet with the left eye and an ophthalmoscopic study showed edema of the optic disc and congestion of the retinal veins. Roentgenographic study of the chest on Feb. 3, 1933 (Fig. I-A) showed infiltration through the upper two-thirds of the right pulmonic field with multiple small patches of deposit through each lung. There was extensive destruction of the ribs and lumbar vertebræ. The skull showed multiple metastases (Fig. 2-A). Therapy consisted of 475 roentgens anteriorly and posteriorly over the pelvis, 200 kv.p., through 0.5 mm. Cu and 2 mm. A1, 60 cm. distance, 20 × 20 cm. port. Also, 475 roentgens were delivered anteriorly and posteriorly to the spine and chest and 475 roentgens laterally to the skull. Pain in the back was relieved within a few days, vision gradually improved, and the cough was alleviated after six or eight weeks.

Vanadiferous Nodules in Worcester Clay

THE presence of dark nodules in the red Permian marls of South Devon has been recorded1. These nodules, which range from pin points to masses of many pounds in weight, attain their maximum development one mile west of Budleigh Salterton. They are surrounded by aureoles of green clay, contain some 14 per cent of vanadium (estimated as V2O5) and are radioactive.

Megaduodenum and Duodenal Obstruction

MEGADUODENUM is said to have been described as early as the middle of the eighteenth century (1). It has taken a place in clinical medicine since roentgen study of the gastro-in-testinal tract became a part of diagnostic procedure. The possibility of intermittent obstruction at the duodenojejunal angle has been recognized and a causal connection with megaduodenum has seemed demonstrable to some. It is the purpose of this paper to present a case of megaduodenum and to discuss the criteria for diagnosis of duodenal obstruction. Case 1. A young girl, 18 years old, born in England, had lived with her parents in different countries where her father's business had taken them. He was a mining engineer and his work had not only required their living in different countries but also for periods, in out-of-the-way places where their choice of food was limited and living conditions otherwise primitive. The patient had a lateral curvature of the spine and had been subject to digestive upsets when she would vomit, complain of abdominal distress, and be incapacitated for short periods. After these attacks she would make rapid recovery. The attacks had been regarded rather indefinitely as “regular children's vomiting” and had become less frequent as time went on. Shortly before being seen, the patient had been operated on for her spinal deformity and an extensive plaster cast was applied, encasing her entire body. The day after the operation she began to vomit and continued to do so whenever she ate. In ten days she had lost as many pounds in weight. The films shown in Figures 1 and 2 were made. A hole was cut in the cast and the ascending colon was lifted, with the hand inserted in the hole thus made. Postural treatment was suggested, with the patient lying on her stomach and walking on her hands and knees. A liquid diet was given at first and then soft solids. A symptomatic recovery resulted almost immediately and this was continuous, after the cast could be removed. Both megaduodenum and duodenal obstruction have been described at length and various views of a possible relationship have been expressed. The papers of Bockus (2) and Kellogg (3), and the monograph of Duval (4) give the history of the development of knowledge concerning the two conditions and give extensive bibliographies. Duodenal obstruction has been described with pressure of peritoneal bands (5, 6) congenital and inflammatory, the latter secondary to peptic ulcer (7, 8), biliary and pancreatic infections, malignancy of the stomach or of neighboring organs, or the pressure of the newgrowth or other pressure from without, or obstructive pathology of the duodenum itself.

Abdominal pregnancy near term, operation and hormonal studies of the blood and urine with the placenta left in situ

T HE patient, who was thirty-four years of age and of Italian extraction, was admitted to the Norwegian Hospital on Nov. 18, 1935. Her physician had advised hospital care because of the severity of nausea, vomiting, constipation, and painfulness of fetal movements. Her past history aside from her menstrual, marital, and obstetric history was irrelevant. Her menses began at thirteen, occurred regularly at twenty-eight-day intervals and were of four-days duration, being associated with moderate dysmenorrhea. She had first married in 1919 and two pregnancies occurring shortly thereafter were terminated by induced abortions at three months and apparently were not followed by sepsis. After living with this husband for two years she divorced him and remarried in 1924. She did not conceive again until 1929 at which time a left salpingectomy was performed for a ruptured ectopic gestation. There were no pregnancies from then on until the one under consideration. The last menstrual period began on March 15, 1935 at the expected date and was normal in all respects. About four weeks later she began to spot and experienced cramplike pain such as she would have during her periods. This spotting and pain continued for the next two weeks, the bleeding on one occasion amounting to a definite flow for several hours. There was no further bleeding during the remainder of the pregnancy. Pain along the entire right side of the abdomen and chest was present at intervals associated with attacks of weakness. The pain was often relieved by enemas. Nausea and vomiting were a prominent symptom throughout, the patient losing eighteen pounds in weight. Constipation was a persistent symptom also. In the last trimester the fetal movements caused the patient great distress in the upper abdomen. I first saw her in consultation on November 27, three and one-half weeks prior to her estimated date of confinement. The patient was found to be a poorly nourished individual with a diminished hemic component, who did not appear well. Her temperature was 98.2” F., pulse 85, respirations 20, and blood pressure 116/76. Physical examination revealed no abnormalities aside from evidences of weight loss, the breast signs of pregnancy and the abdominal findings. The abdomen was greatly enlarged as though by a twin pregnancy. What first appeared to be the fundus uteri was found to be 27 cm. above the symphysis, and there seemed to be a marked widening of the upper portion of the abdomen. Palpation revealed, however, that the child was in the upper abdomen lying transversely with the head on the left side just beneath the co&al margin. The fetal parts were unduly prominent. The right lower quadrant of the abdomen was occupied by a semisolid fixed mass with a rounded upper edge which extended upward to slightly above the umbilicus and appeared to arise from the pelvis. This mass seemed to fuse with another mass which was also present in the lower abdomen to the left of the first mass extending over into but not completely filling the left lower quadrant and rising to the level of the umbilicus. The fetal heart was heard in the upper left quadrant. On vaginal examination the cervix was found high up

Bilobed Gall Bladder (Vesica Fellea Divisa)

Anomalies of the gall bladder in the human being are rare. We are indebted to Boyden (1), who has made an extensive study of the gall bladder in both animals and man. Recently Gross (2) published a very comprehensive article listing six cases of bilobed gall bladder which he was able to find in the literature, only one of which was diagnosed by cholecystography. An additional case that was recognized by the above procedure and confirmed at operation is submitted. The roentgenologist should be familiar with these malformations in order that an unusual shadow of the gall bladder may be correctly interpreted. With the increasing use of cholecystography, it is probable that these anomalies will be found with greater frequency. Boyden found cats had bilobed gall bladders in about 10 per cent of the total number he examined. Embryologically, a bilobed fundus is explained as follows: The single bud becomes paired, but a primary connection is maintained, thus forming two separate and distinct fundi with a single cystic duct. In two of the previously reported cases, the external appearance of the gall bladder showed quite a longitudinal septum. In the others and our own case, there are two separate cavities. The clinical evidence is not characteristic of an anomaly. Case History Female patient, aged 37 years, complained of a pain in the abdomen, with no particular relation to type of food or time of eating. There was no history of vomiting, or jaundice. She had lost about thirteen pounds in weight in six months' time. Physical examination was normal, except for tenderness on palpation of the abdomen, particularly on the right side. The pam seemed to radiate equally in all directions. Blood count was within normal limits. Gastric analysis at the end of fifty minutes gave 25º free hydrochloric and a total acidity of 45º. Occult blood, lactic acid, and microscopic examinations were negative. Roentgenoscopic and radiographic examinations of the gastro-intestinal tract revealed no abnormalities. A plain film of the gall-bladder area showed no demonstrable pathology. The gall-bladder dye was given intravenously, radiographic observation being made at four and six hours and one hour after a fat meal. The interpretation of the films was as follows: “Th.e gall-bladder shadow can be definitely outlined four hours after the intravenous administration of the gall-bladder dye. The gall bladder appears to be divided into two parts. This is further visible at the end of six hours. One hour after the fat meal, this division of the gall-bladder shadow can be more clearly outlined, the gall bladder having emptied itself over 80 per cent. The diagnosis arrived at is bilobed gall bladder.” At operation a bilobed gall bladder, with one cystic duct, was found. A partial cholecystectomy was done. The appendix was removed.

The Pre-operative Diagnosis of Cholecystocolonic Fistula

Although the pre-operative diagnosis of cholecystocolonic fistula has been previously reported, it is by no means a common finding. Podlasky (4), in reviewing the literature previous to 1935, stated that he was the second observer to report such a case. He credits Judd and Burden (2), whose article appeared in 1925, with being the first to report this condition. Since that time similar findings have been reported in both the American and foreign literature. The case which we report is unusual, because of the mildness of the patient's symptoms at the time of the rupture of the gall bladder into the colon, and because of the complete filling of the bile ducts, which we have found only once (6) in our search of the literature. The patient, E. M., white, male, aged 65 years, was referred to us by Dr. H. J. Anderson, Titusville, Pa., for gastro-intestinal examination. Present Illness.—Two years before admission the patient had a severe attack of what he termed “intestinal flu.” At that time he had a high temperature, nausea and vomiting, and a severe diarrhea, having as many as eighteen stools a day. He did not consult a physician, because other members of his family had the same condition, which cleared up in a few days. The patient, however, continued to have the severe diarrhea and at the time he was sent to us was having six to eight stools a day. He stated that he had lost about twenty-five pounds in weight during that time. Past History.—The usual childhood diseases were mentioned, but no history of any acute illness was elicited. Four years before he had visited a large clinic because of a vague abdominal discomfort, and a gastro-intestinal series was done, but apparently no pathology was seen at that time. Examination.—On examination of the stomach, and a six-hour plate, no evidence of pathology could be made out. All the barium had left the colon at the end of the 24-hour period. A barium enema was done, which showed the colon to fill well. The ascending colon was somewhat spastic. No filling defect could be seen at the hepatic flexure. The patient was then turned upon his abdomen and almost instantly the bile ducts became filled with barium. A careful study of the six-hour examination does show some irregularity at the hepatic flexure, but the true nature of the condition could not be diagnosed from this film. Air in the bile ducts, which is said to be a diagnostic sign, is not seen on any of these films.

Leiomyosarcoma of the Duodenum: Report of Case

Only three cases of leiomyosarcoma of the duodenum have been reported to date, the first by von Salis (1) in 1920, the second by Andersen and Doob (2) in 1933, and the third by Silverstone (3) in 1934. The following case is the fourth known instance of leiomyosarcoma arising in the duodenum. Report of Case J. S., a white male aged fifty-four, a machinist by occupation, was admitted to the William J. Seymour Hospital on Nov. 11, 1935, and died Dec. 1, 1935. The chief complaints on admission were pain in the abdomen, loss of weight, itching and jaundice. Up to three months previously the patient had felt perfectly well. At that time he noticed a gradual onset of pain in the upper abdomen below the ribs. He could not take food and vomited frequently after meals. The pain was sharp or burning in character, and occasionally radiated to the back or up into the left chest. He had had no previous stomach trouble. He complained, also, of itching all over his body for the past week, and was told that his skin was yellow. Since the onset of his illness he had had dryness of the mouth and skin and increased thirst, but no increased hunger and no frequency of urination. The appetite was poor. Although the patient stated that he had lost 60 pounds in weight in the last six months, he appeared well nourished. The patient had had an appendectomy in 1930 for a ruptured appendix. In 1920 he lost his left thumb in an accident. An injury by a piece of steel in 1920 caused loss of sight in the right eye, which was enucleated. A similar injury to the left eye in 1927 caused total blindness. Alcohol was used in moderation.

Protection of Wild Life in Africa

THE Convention for the Protection of the Fauna and Flora of Africa, signed on behalf of nine Govern-ments in London on November 8, 1933, became effective on January 14, 1936. The ratified articles have therefore come into force in all the African territories of Great Britain, Belgium, Egypt, the Anglo-Egyptian Sudan and the Union of South Africa (Science Service, Washington, D.C.). As a result, gorilla, okapi, white rhinoceros, pigmy hippopotamus and eighteen other rare wild animals, together with the unique plant of the Kalahari Desert, Welwitschia, are now absolutely protected. Protection almost as complete is afforded to a series of animals in List A, which may not be killed for ordinary purposes at all, either by natives or whites, but may be taken in strictly limited numbers, with Government permission, for important scientific purposes. There are included such African elephants as possess tusks less than ten pounds in weight. If the tusks be heavier than ten pounds, the elephants fall into Class B, where they are partnered by black rhinoceros, the two species of giraffe, the wild ostrich and several kinds of egrets and hornbills. Class B animals may be hunted only by special licence, whereby the area, time and extent of the hunting is strictly limited and defined.

The relation in man between gastric acidity and height and weight

A study of 2,185 normal persons showed that, with age and height constant, free gastric acidity increased in women 0.06 units for each added pound of weight. There was no such relation in the case of men. With age and weight constant, free gastric acidity increased in men 0.08 units for each added inch in height. In women the acidity was lowered by 0.02 units for each added inch.

Primary Melanotic Sarcoma of the Esophagus: Report of a Case

Primary malignant melanotic tumors of the esophagus are extremely rare, as evidenced by the fact that only three have been found in the literature, namely those of Baur (1), Joliat (2), and Voss (3). Metastatic melanomas however, are not unusual in the gastro-intestinal tract, where they may involve either the mucosa or submucosa. In the present case, as well as in those reported previously, the diagnosis of esophageal tumor was not made until after death, since there were no signs of esophageal obstruction. Case Report J. R., a man aged sixty-nine, entered St. Luke9s Hospital July 6, 1933, complaining of a feeling of fullness in the epigastrium and the expectoration of large amounts of mucus, over a period of six weeks. Expectoration was usually accompanied by some coughing, and occurred a few minutes after eating. There had been a loss of forty pounds in weight during this time. Thirty years before admission the patient had punctured the left eyeball. This healed promptly and produced a scar of the right cornea, which caused complete blindness in that eye. Since the healing of the eye there had been no further change in its appearance. Other than this the patient had always been in good health.

Primary Carcinoma of the Jejunum: A Case Report

Primary carcinoma of the jejunum is of rare occurrence. The actual number of cases so diagnosed is difficult to determine since carcinomas of the three divisions of the small intestine are generally grouped together in autopsy and operative statistics. Bollag recently collected 9 cases, to which he added one of his own. His paper includes a discussion of the incidence, symptoms, diagnosis, and results of treatment. The following case was seen in the Santa Clara County Hospital, San Jose, California. Case Report D. S., age fifty-four years, a white, male, restaurant worker, was admitted to the Santa Clara County Hospital, on Nov. 2, 1933. He had been perfectly well until six weeks before admission, when he experienced severe pain in the epigastrium with nausea and vomiting. One week later he had an attack of pain in the right lower abdomen, also associated with nausea and vomiting. Pain continued to recur spasmodically, and for three weeks prior to hospitalization the patient was unable to hold anything in his stomach. He had had no bowel movement for five days, in spite of repeated enemas. No blood had been noticed in the stool. There had been a loss of ten pounds in weight. Physical examination revealed marked emaciation, the patient weighing only 113 pounds. There was considerable tenderness in the right lower abdomen, with a mass in this area which disappeared on pressure. Peristaltic waves were visible. Rebound tenderness was present over the entire abdomen; there was no definite rigidity. Other physical findings were normal. The blood pressure was 110/80.

Carcinoma of the Stomach

My object in reporting this case of carcinoma of the stomach is not so much that I wish to present anything particularly different from other x-ray findings but that my pre-operative diagnosis was that of a benign tumor or papilloma. This case was referred by Dr. A. J. Walscheid for roentgenographic examination Feb. 14, 1927. Roentgenoscopic examination of stomach after a barium suspension meal shows that the stomach is situated to left of median line, greater curvature is even, and is 4.5 inches below the umbilicus. On palpation near the pylorus, a distinct mass about 1.5 inches in size, not movable, is felt between the palmar surfaces of the fingers. Films taken in the upright, prone, and in the right lateral view, show that near the antrum of the stomach there is a faint irregular rarefaction, ½ × ⅞ inch in size : the first portion of duodenum is somewhat irregular. Examination, six hours after the barium suspension meal, shows a faint residue in the stomach. Rest of gastro-intestinal tract is negative. History.—Seven months ago, J. P., aged 43 years, began to have discomfort about one hour after meals, frequently vomiting his entire meal. He has lost from 13 to 20 pounds in weight; at times he gains only to lose again. Operation was performed March 10, 1927. A subtotal gastrectomy, Balfour method, jejunal-jejunostomy was performed. Report from Pathological Laboratory.—The specimen is composed of a portion of tissue removed from the pyloric extremity of the stomach. There is an ulcerated area, 3⅓ cm. in diameter at the lesser curvature. This lesion presents a definite circumscribed margin with crater-like edges. Section shows that the lesion is confined to the mucosa and does not infiltrate the submucosa. Microscopic examination has been made of sections through the edge of the ulcerated area of the pylorus, and also at the base. Examination of the structure at the edge shows that a portion of the surface is covered with mucosa and its glands, but the submucosa has been replaced by a tumor process which is characterized by atypical columnar epithelial cells with an alveolar arrangement. These cells vary in size and shape and they contain a vesicular nucleus; an occasional mitotic figure is observed. The stroma is scanty, and is densely infiltrated with round inflammatory cells and polynuclear leukocytes. In areas in which the mucosa is not observed, there is some necrosis on the surface. Microscopic examination of sections at the base shows complete absence of the mucosa and muscularis mucosa. The submucosa is completely replaced by a tumor process characterized by various sized groups of atypical epithelial tumor cells in a cellular connective tissue stroma. This process has infiltrated the muscle coats but does not extend entirely through them. Diagnosis.—On March 13, 1927, the diagnosis was carcinoma of the stomach. The patient was referred to me again on April 26, 1927, for a series of deep roentgen treatments.

Influence of Sex on Utilization of Feed in Turkeys

THE fact that Bourbon Red male turkeys weigh on an average approximately 50 percent more than females at seven months of age suggests that possibly the male uses less feed for each pound of weight than the females.The data available at the present time for feed used by chickens and turkeys at different age and weight periods are usually based on flocks carrying both sexes. These data do not show whether there is a difference between the male and female in the amount of feed used per pound of weight.Data collected by Roberts and Carrick (1933) on Barred Plymouth Rock chicks from four to ten weeks of age, show no difference in the feed used for each pound of weight by the different sexes.Data reported by Jull and Titus (1928) on crossbred chicks, from day-old to twenty-four weeks of age with male and females separated, show a .

Field Notes on Some Amphibians from British Guiana

THESE observations on certain amphibian species were made in British Guiana incidental to the collection of herpetological material for histological studies. 1. Bufo marinus (Linnaeus) These very common toads appear as dusk approaches. On rainy nights they make considerable noise flopping on the wet ground. Individuals are frequently well over a pound in weight, and are hence the largest amphibians of the country. The volume of the voice is exceeded only by that of Hyla maxima. Above, the color is a rich brown touched with brighter tones, while large dark spots make a pattern. Young specimens are very variable, but tend to show a darker ground color than the adults. Specimens preserved included one from Matope, one from Amatuk, one from Upper Camaria and 52 from the Kartabo region. Many others were seen, especially in Georgetown, where they gather in the evenings under the street lamps to catch insects.

A Case of Sarcoma of the Stomach

The patient, a married woman aged 59, was first seen in May, 1932. Faintness and loss of colour had appeared suddenly nine days before, and had been followed for some days by black motions. She had not vomited. On close questioning she admitted to some mild epigastric discomfort for about nine months; this had been irregular, without relation to meals and especially noticed in the evenings. She had had no nausea, vomiting, anoresxia or flatulence, and her bowels had been regular. She had lost a few pounds in weight during the previous months. Fifteen years earlier she had had an acute attack of severe abdominal pain; gastric ulcer had been diagnosed and operation advised, but the pain had subsided in three weeks with rest and diet, and no radiogram had been taken. At examination there was some dyspnoea on exertion, the conjunctivae were pale, and a small area of deep tenderness was felt an inch above and an inch and a half to the right of the umbilicus. Otherwise she appeared normal; there was no palpable ...

Myxedema

Article1 June 1932MyxedemaA Case Report*HENRY B. GOTTEN, M.D.HENRY B. GOTTEN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-5-12-1492 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptClassical myxedema is seldom seen. The case reported herein is interesting in that it presents practically all the characteristics of an extreme hypothyroidism.Mrs. W. D. H., aged thirty, came to the clinic on November 17, 1930, complaining of exhaustion, lack of energy, and weakness, and stating that these symptoms had persisted since the birth of her last child, seven years earlier. She had spent a part or all of each day in bed for a number of years. During that time she had gained about thirty pounds in weight. Menstruation was irregular; the periods appeared every six to eight...References1 CHANEY WC: Tendon reflexes in myxedema: a valuable aid in diagnosis, Jr. Am. Med. Assoc., 1924, lxxxii, 2013-2016. CrossrefGoogle Scholar2 CHRISTIAN HA: Diagnosis and treatment of heart disease, Oxford Monograph, iii, Oxford University Press, New York, 279. Google Scholar3 DAVIS JC: Myxedema heart with report of one case, ANN. INT. MED., 1931, iv, 733-741. LinkGoogle Scholar4 FAHR G: Myxedema heart, Jr. Am. Med. Assoc., 1925, lxxxiv, 345-349. CrossrefGoogle Scholar5 FAHR G: Myxedema heart, Am. Heart Jr., 1927, iii, 14-30. CrossrefGoogle Scholar6 MACæENZIE GM: Anemia in hypothyroidism, Jr. Am. Med. Assoc., 1926, lxxxvi, 462-464. CrossrefGoogle Scholar7 STONE CT: The occurrence of anemia in myxedema, ANN. INT. MED., 1928, ii, 215-221. Google Scholar8 ZONDEK H: Das Myxödemherz, München, med. Wchnschr., 1918, lxv, 1180-1182. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Memphis, Tennessee*Received for publication, September 12, 1931. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byNeurologic Manifestations of MyxedemaThe nervous and mental manifestations of myxcedema 1 June 1932Volume 5, Issue 12Page: 1492-1496KeywordsBirthHypothyroidism Issue Published: 1 June 1932 PDF downloadLoading ...

A Case of Aneurysm of the Abdominal Aorta

Since cases of abdominal aneurysm in which the symptoms are suggestive of renal stone are rather infrequently encountered, and also because the aneurysm is rarely found to have penetrated through the diaphragm, it is believed that the following case history will be of interest. A man, 46 years of age, entered the Clinic complaining of “kidney trouble” and backache. The symptoms had been noticed, first, nine months previously, at which time he experienced pain in the kidney region of the left side and back, radiating downward to the flank, the distress persisting for several days. He had frequency but there was no hematuria. The pain had subsided after the patient's physician had given him a dose of medicine and he apparently remained well until five days before he entered the Clinic, when another attack occurred; since then, the pain had been severe and constant. Relief could be obtained only by standing and leaning to the left side. The patient had lost fifteen pounds in weight. The personal history revealed nothing of significance, and upon physical examination no gastro-intestinal symptoms were found to be present. There were no significant findings in the urologic examination, except for signs which led to the suspicion of an aneurysm of the left renal artery. There was no shortness of breath, no palpitation, no edema. The pulse rate was 120 and the blood pressure 150/100. A general examination of the chest showed nothing of significance and no masses could be palpated in the abdomen. A diagnosis was made of left kidney stone, neoplasm of the left kidney, arteriosclerosis and hypertension, and the patient was advised to enter the hospital. A roentgenographic examination of the abdomen by means of pneumoperitoneum disclosed a large abdominal aneurysm. On February 11, 1929, under spinal anesthesia, a left oblique lumbar incision was made and the left kidney exposed. No evidence of a tumor or a stone was found, but the lower pole of the kidney was soft. The kidney was removed. Just above the kidney area and beneath it, a pulsating mass could be seen from which dark blood flowed after a needle was inserted. This mass was believed to be an aneurysm of the abdominal aorta originating just below the diaphragm. As it was not possible to institute surgical treatment for this condition, the wound was closed. The patient made an uneventful recovery. On November 11, 1930, the patient returned to the Clinic complaining of pain in the left lumbar area from which he had suffered for several months. There was marked restriction of movement in the upper lumbar area. Roentgenographic examination showed the bodies of the first lumbar and the eleventh and twelfth dorsal vertebrae to be about half destroyed by the aneurysm. Marked right scoliosis was noted. On December 12, 1930, a roentgenographic examination of the gastro-intestinal tract showed no evidence of a pathologic condition either in the stomach or colon.

Common Bile Duct Emptying into Duodenal Diverticulum

The etiology of duodenal diverticula still remains a disputed question. Keith felt that the lesions were acquired because of traction from without, as adhesions following gallbladder disease or pancreatitis. The case here reported is of interest because it presents the combination of a duodenal diverticulum, caused apparently by the traction of adhesions about the common bile duct and the duodenum, and secondly, because of rather prominent longitudinal markings in the lower third of the esophagus, which proved to be varicosities. History.—The patient was a male, Italian farmer, aged 53. He entered the hospital with a complaint of intermittent dull pain in the epigastrium and left upper quadrant, which dated back about one and one-half years. The pain was accentuated by food and not relieved by ordinary medical remedies. The attacks would start in the mid-epigastrium, radiate to both upper quadrants, and were sufficiently severe to double the patient up. They were accompanied with nausea but no vomiting except on two occasions, one just before, and a second two weeks after, entry into the hospital, when the patient vomited about one pint of bright red blood. His stools had been tarry on several occasions. Within the month previous to entry the patient had lost about 15 pounds in weight. His past history and family history were negative except for the habit of drinking wine with all meals. Physical Examination.—The mucous membranes were pale. The lung findings suggested emphysema. The heart sounds suggested a mitral insufficiency and the vessels were markedly sclerotic. Throughout the upper abdomen there was definite guarding and tenderness. On deep palpation an indefinite mass was felt across the upper abdomen. The laboratory findings revealed a moderate secondary anemia and a leukopenia. The stools gave a markedly positive guaiac test while on a meat-free diet. The Rose Bengal liver function test showed evidence of liver damage. At this time it was felt that the patient's disease was carcinoma of the stomach, with metastases to the liver, consequently a roentgen examination of the gastro-intestinal tract was made. There was a definite but slight dilatation of, and delay in, the lower part of the esophagus. Markings, simulating those of rugal lines, were more definite than usual in the lower end of the esophagus. The cardiac end of the stomach showed some hypertrophic rugae. Peristalsis passed completely over the usual portions of the stomach. The duodenal bulb was quite large and was definitely indented in the apical region. The posterior part of the first portion of the duodenum appeared to be somewhat lower than normal, relative to the cap. There was a large bilobed diverticulum extending to the left of, and slightly anterior to, the lower third of the descending portion of the duodenum. At six hours the stomach and diverticulum were empty. The remainder of the tract was not remarkable. Pathological Report.