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RM2AG63TT–. Selected monographs, comprising Albuminuria in health and disease. o j^liysicalconditions which oppose the descent of the kidneys, especiallythe adsijiratory force of tlie diapJiragm and the intra-ahdominalpressure produced by the normal act of straining. If one ofthese factors is eliminated in experiments on the dead subjectas may be done by opening the abdominal cavity or removingthe diaphragm, the kidney is seen almost invariably to sinkslightly by virtue of its weight. In spite of this, the anato-mical fastenings are so strong, that Sappey found as a resultof 24 experiments in which the
RM2AKGF1N–Typhoid fever and typhus fever . htdays and more, either with regularly re-peated remissions, or—and this appliesespecially to severe cases—days of highcontinued fever alternating with othersof remittent continued fever. Less com-monly, in my experience, beginning im-provement is characterized by the circum-stance that the high average temperaturegradually subsides without increase inthe remissions or with only isolatedconsiderable daily fluctuations. The less common cases of severeprotracted course in childhood exhibitwith especial frequency a form of tem-perature-curve with marked remissions
RM2AKGM2K–Typhoid fever and typhus fever . hi 6 I Copyright, 1901,By W. B. SAUNDERS & COMPANY. Registered at Stationers Hall, London, England. ELECTROTYPED BYWESTCOTT & THOMSON, PHILADA. PREFACE. The excellence of the series of monographs issued under the editor-ship of Professor Nothnagel has been recognized by all who are suffi-ciently familiar with German to read these works, and the series hasfound a not inconsiderable proportion of its distribution in this andother English-speaking countries. I have so often heard regret expressedby those whose lack of familiarity with German kept these works beyon
RM2AKG96E–Typhoid fever and typhus fever . he fact that the proportion of 8.4 per cent, of cases in which tworelapses occurred, as disclosed by the Hamburg statistics, exceeds thatyielded by my previous and subsequent experience. I believe the occur-rence of such cases to be, on the average, much less frequent—4 per cent,would probably represent the usual conditions. With reference to the severity of repeated relapses, this appears tome to be generally slighter than that of the first relapse or of the recru-descence. The contrary, however, is not altogether rare. Thus, lastyear I saw in consultation a s
RM2AKGG3M–Typhoid fever and typhus fever . e the average morning level is from 39°to 40° C, and the evening level up to 40.5° C. and above. Of itself it is of grave omen if with a hightemperature but slight morningremissions take place, especiallyif the temperature remains un-influenced in spite of the em-ployment of cold baths or otherantipyretic treatment (Fig. 14).If the temperature be especiallyhigh, possible complicationsshould be carefully looked for.Septic conditions, pneumonia,and secondary meningitis areespecially to be kept in mind. At times the severe contin-ued fever is interrupted by oneor
RM2AGABGX–. Selected monographs. re also 2ihysicalconditions which oppose the descent of the kidneys, especiallythe adspiratory force of the diaphragm and the intra-abdominaljjressure pioduced by the normal act of straining. If one ofthese factors is eliminated in experiments on the dead subjectas may be done by opening the abdominal cavity or removingthe diaphragm, the kidney is seen almost invariably to sinkslightly by virtue of its weight. In spite of this, the anato-mical fastenings are so strong, that Sappey found as a resultof 24 experiments in which the cadaver was raised ujDright,that the kidney
RM2AG62YW–. Selected monographs, comprising Albuminuria in health and disease. rted by a series of important reasons. We have already discussed the relation of the renal vessels-and ureter during descent and rotation of the kidney, a rela-tion which is of great importance for the train of symptomsbefore us. We have also already found the acute angularcourse and torsion of the renal vessels established by someautopsies. In order, however, to bring these relations moreprominently into view I have got some preparations ofkidneys made artificially moveable in the dead subject drawn,these preparations shoAvi
RM2AGA9B8–. Selected monographs. Right kidney, twisted on its hori-zontal axis, and with its ontcrborder looking downwards. Right renal artery. Right renal vein. 4. Right ureter, kinked and twisted. 5. Abdominal aorta.(). Vena cava inferior. 7. Left kidney in its normal situa-tion. numerous cxpeinmcnts involviuf^ tLo ligature and artificialnarrowing of the renal vein. In this relation however thedisturbance of the circulation, even when it occurs more orless contemporaneously with the disturbance of the circulation,is secondary, and caused by the alteration in the secretion.But I must affirm, contrary t
RM2AGA8EY–. Selected monographs. Fistulous opening in tlic abdominal wail from the pelvis of tlie kidney.. to have contracted, but otherwise to have undergone butlittle change in relation to the wound. The fistulousopening which remains, situated at the inner angle of thewound, is only about one centimetre in diameter. (9) Peculiar conoiection between Moveable Kidney and Hydro-nephrosis {Egery. Frau M—, 29 years of age, had been deli veiled of a sonten years previously. Nine months later she began to feel aslight gnawing pain in the left lumbar region, which dis-appeared after a short period of recumben
RM2AGAAT7–. Selected monographs. ndcardiac end of the stomach, bears the pressure of the bodic&with impunity. (e) According to Mtiller-Warneclc also the liver, andtherefore the right kidney which normally lies distinctly thelower down,^ are sjDCcially affected by laced bodies. Thissupposition is, however, not to the purpose, for normally theright kidney lies very slightly if at all lower down than theleft, so that the left kidney being deprived of the protectionof the bulky liver must be much more exposed to pressurethan the right. (/) Other authors make the liver alone answerable for thefrequency of mo
RM2AKGEK8–Typhoid fever and typhus fever . following the first afebrileevening the temperature will be between 35° and 36° C. The tem-perature then varies in different cases : it may—as is not uncommon 150 TYPHOID FEVER. and has been described—remain subnormal for a week and longer, thestage of emaciation thus following immediately. In other cases, afterthe normal has been reached, there follow more or less marked, irregularfluctuations in the curve, through which the physiologic evening tem-perature is reached and probably also is exceeded. After this has con-tinued for a few days and the disease tends
RM2AKGE9P–Typhoid fever and typhus fever . ay exhibit its influence upon the pulsebefore the discharge has taken place externally. With reference to 156 TYPHOID FEVER. intestinal hemorrhages, it is especially to be borne in mind furtherthat, if at all considerable, they give rise to rapid fall of the tem-perature. This fall of temperature and the increase in pulse-frequencygive rise to those intersections in the curve (Fig. 24, p. 222, Digestion)familiar to the experienced clinician as most ominous. That an entirelysimilar relation between pulse and temperature may also attend states ofcollapse of other
RM2AKGAE7–Typhoid fever and typhus fever . 348 TYPHOID FEVER.. RECRUDESCENCES AND RELAPSES. 349 If this be compared with the rather rare cases in which it was possibleto make observations of the pulse as early as the period of incubation, astriking coincidence of the pulse-tracing before the beginning of theprimary attack with that preceding the relapse will be disclosed.There will also be found a resemblance between the relapse and theprimary attack, manifested in the temperature-curve,1 and in manyother features besides. An instructive instance of- a mild relapse with the characteristicfeatures of pul
RM2AKGGG8–Typhoid fever and typhus fever . ally lead the trained ob-server in the right direction.Invariably, and almost in atypical manner, it occurs re-peatedly that dwellers in ahospital, for instance, servants,laborers, mechanics, who ex-hibit only general symptomsand apparently are free fromfever, are sent to the hospitalwith an indefinite diagnosis,and sometimes with a suspi-cion of simulation. Undersuch circumstances no especialorganic alteration will in factbe found, and only on carefulobservation of the abnormallymarked fluctuation in thedaily curve and the instabilityof the pulse will attentio
RM2AKGE38–Typhoid fever and typhus fever . tly before or atthe height of the fever, at times even durmg the ascent, the patientsbecome stupid. They are delirious at night and sometimes by day, andlie in a state of relaxation, in passive dorsal decubitus, with the mouthopen, exposing the dry, fissured tongue and lips. Subsultus tendinum, VARIATIONS IN SYMPTOMS AND COURSE. 289 floctitation, and grinding of the teeth, in young persons even convul-sions, increase the gravity of the clinical picture. Not rarely rigidityof the back with opisthotonos and other cerebrospinal symptoms arepresent besides. The sta
RM2AGAAJW–. Selected monographs. supported by a series of important reasons. We have already discussed the relation of the renal vesselsand ureter during descent and rotation of the kidney, a rela-tion which is of great importance for the train of symptomsbefore us. We have also already found the acute angularcourse and torsion of the renal vessels established by someautopsies. In order, however, to bring these relations moreprominently into view I have got some preparations ofkidneys made artificially moveable in the dead subject drawn,these preparations showing some kinds of twisting and kink-ing of t
RM2AKG77M–Typhoid fever and typhus fever . Fig. 70:—Male, aged sixty-three. Fatal termination with relatively low fever. present in small numbers and were very indistinct; but, on the other hand,numerous petechia? made their appearance early among the roseola lesions. Day of the disease.. 4 m
RM2AG61GN–. Selected monographs, comprising Albuminuria in health and disease. 1. Right kldnev, twisted on its hori- zontal axis, and witli its outerborder looking downwards. 2. Eight renal artery. 3. Right renal vein. 4. Right ureter, kinked and twisted. 5. Abdominal aorta. 6. Vena cava inferior. 7. Leit kidney in its normal situa- tion. ?numerous experiments involving the ligature and artificialnarrowing of tlie renal vein. In this relation however thedisturbance of the circulation, even when it occurs more orless contemporaneously with the disturbance of the circulation,is secondary, and caused by th
RM2AKGH08–Typhoid fever and typhus fever . n peculiar arrangement. Theyare distributed throughout the organin the form of innumerable irregu-larly arranged groups, in which thebacilli lie so close together that instained sections they appear as dark,opaque spots, at the periphery ofwhich individual bacilli may berecognizable (Fig. 7). In other respects the histologicalterations are in general scarcelydifferent from those of the acuteinfectious splenic tumor: In the early stage, especially hyperemia,particularly with overdistention of the cavernous veins of the pulp,and with further advance in the morbid
RM2AKGHEP–Typhoid fever and typhus fever . Fig. 1.—Typhoid-bacilli; impress-preparation. the extremities as well as in the middle of the bacilli were thoughtto be spores. These are at the present time considered as deficiencies,attributable either to a process of involution in the bacilli or as anartefact developed in heating and staining (H. Büchner)..
RM2AKGJCK–Typhoid fever and typhus fever . ded extremities, about thrice as long as theyare wide, and in absolute length one-third the diameter of a red blood-corpuscle. In ulcerated Peyers patches and in other parts at the heightof the specific lesions the bacilli form, by longitudinal application to oneanother, filamentous structures, first described by Gaff ky as pseudo-filaments. Under various circumstances the bacilli undergo changes inform, size, and arrangement. Thus the pseudo-filaments alreadymentioned will be found in old bouillon-cultures or gelatin-cultures,as well as on potato of acid react
RM2AGA83A–. Selected monographs. urne ... Sydney Cbristclnircli Nelson Napier, Ilawkes B;iy Toowoniba, Brisbane Montreal .. E. F. Brockman, M.D... K. R. Kirtikar, L.R.C.P. S. Australia. Victoria. Edward Barker, M.D. New South Wales. New Zealand. J. Irving, M.D. F. L. De Liblc, M.D. Queensland. Canada. 44 THE NEW SYDENHAM SOCIETY. Abingdon, IIIBaltimore ..BostonCincinnati ..New York ..Philadelphia United States. .. Madison Eeece, M.D. .. E. H. Salter, M.D. Messrs. J. H. Vail & Co.Eicliard J. Dunglison, M.D.(Mr. Presley Blakiston). Barbadoes.Eobert E. Walcot, M.D. Japan. Yokohama and Yeddo S. Eldridge, M.
RM2AKG83W–Typhoid fever and typhus fever . and justifies thehope that the course of the disease may be abortive (Figs. Q6 and 67). The condition of the kidneys in the abortive forms is usually good.Slight degrees of albuminuria may occur : marked excretion of albuminwith blood I saw in only 1 case, and that was of rather long duration, sothat it could hardly be called a distinctly abortive case. I give thetemperature-chart of this case in Fig. 68, as it shows not only the courseof the temperature, but also the occurrence and significance of a rela-tively slow pulse. These cases, it need hardly be said,
RM2AKGC96–Typhoid fever and typhus fever . expense of the initial stage and the period of defervescence, so that theduration of the fastigium with relatively high fever is often rather pro-tracted. With regard to the course of the fever during the latterperiod, the remittent continued type predominates, but complete inter- 300 TYPHOID FEVER. mittence and absolute irregularity in the temperature-curve may existtogether with alarming general manifestations. While, as has been emphasized, the general manifestations in themildest cases of typhoid fever, as well as those referable to singleorgans, are likely
RM2AKGFTN–Typhoid fever and typhus fever . fever, in other respects alsonot attended withalarming symptoms,and which are desig-nated pseudocollapse,I have observed inseveral cases in whichthere were two orthree elevations daily(Fig. 15). The explanation ofthis remarkable, andfrom the prognosticstandpoint generallyindifferent, occurrencewill long remain ob-scure. In the presence ofsuch pseudocollapse,however, the progno-sis should be guardedif the stage of steepcurves does not soonthereafter begin or theintermissions do notactually make theirappearance. Should,on the contrary, thebody-temperature riseaga
RM2AKGBP7–Typhoid fever and typhus fever . re well-developedcases. Also, my 3 cases of that character, the only certain ones thatI have seen, pursued a severe course, 1 terminating fatally. Mod-erately severe and mild cases have been reported but exceptionally.Among these belongs the well-known observation of Gerhardt2 of acase of typhoid fever in a child three weeks old, probably infectedwithin the uterus from the mother. The beginning of the attack of typhoid fever in young childrencan but rarely be determined even in well-marked cases, probably evenless commonly than during the subsequent years of li
RM2AKGA6K–Typhoid fever and typhus fever . RECRUDESCENCES AND RELAPSES. 349 If this be compared with the rather rare cases in which it was possibleto make observations of the pulse as early as the period of incubation, astriking coincidence of the pulse-tracing before the beginning of theprimary attack with that preceding the relapse will be disclosed.There will also be found a resemblance between the relapse and theprimary attack, manifested in the temperature-curve,1 and in manyother features besides. An instructive instance of- a mild relapse with the characteristicfeatures of pulse and temperature j
RM2AKG8N0–Typhoid fever and typhus fever . Fig. 51.—Woman, thirty-three years old. Very severe, uncomplicated case with great cardiacweakness. Marked precritical rise in the temperature. The tendency to marked intermission during the period of defer-vescence, which is almost typical of typhoid fever, is very slight in Day of the disease. Day of the disease.. T 6 f 8 9 10 11 12 13 14 I fl A 40 ^-V--^-, U --- 5 11 ti- v i-v.. «A 38 r 37 t t 1 I«- OC 15 X 36 V,r* 2 35 Fig. 52.—Man, thirty-one years old. Severe case Fig. 53.—Man, nineteen years old. Mod- of typhus fever. Pseudocrisis on the twelfth day er
RM2AG63FG–. Selected monographs, comprising Albuminuria in health and disease. ndcardiac end of the stomach, bears the pressure of the bodicewith impunity. {e) According to MiiUer-WarnecJc also the liver, andtherefore the ^ right kidney which normally lies distinctly thelower down, are specially affected by laced bodies. Thissupposition is, however, not to the purpose, for normally theright kidney lies very slightly if at all lower down than theleft, so that the left kidney being deprived of the protectionof the bulky liver must be much more exposed to pressurethan the right. (f) Other authors make the
RM2AKGBCJ–Typhoid fever and typhus fever . Fig. 33. shortened, as in Gerhardts case. Also the fastigium, and with it theentire febrile period, appears to be generally of relatively short duration,although exceptional cases have been observed that were protracted for Day of the disease.. as long as twenty-seven and even thirty-one days before defervescenceoccurred (Filatow It is noteworthy that in severe cases of typhoid 1 Vorlesungen über Acute Infektionskrankheiten im Kindesalter. Translated intoGerman from the second Kussian edition, Vienna, 1897. VARIATIONS IN SYMPTOMS AND COURSE. 339 fever in infa
RM2AKGDDR–Typhoid fever and typhus fever . re wascomparatively high continued fever, which then declined rapidly in twostages, and complete defervescence occurred after the eighth or the ninthday (Fig. 26). The pulse during the febrile period ranged between 100and 120, and was full and of high tension. Convalescence was uncompli-cated, and the patient was dismissed after three and one-half weeks ready toreturn to work. The temperature-chart shown in Fig. 27 is from a case with nine days offever, on only two or three of which the temperature was high, but which,nevertheless, exhibited a severe, even alar
RM2AKGCEY–Typhoid fever and typhus fever . Fig. 29. subjective complaints and for days a small, although not unduly frequent,pulse. This is an example of almost complete intermittence of the tempera- Day of the disease.. ture-curve from the first day of observation, and probably from the beginningof the fever (Fig. 30). The patient was a girl, fifteen years old, in whomenlargement of the spleen was demonstrable on the fifth day, with moderate 298 TYPHOID FEVER. distention of the abdomen and slight tenderness in the ileocecal region, andfrom the seventh to the thirteenth day two or three thin, pea-soup-l
RM2AKG9D4–Typhoid fever and typhus fever . . to ^s. * > M »-«-- - W S to > ^ OS ^ ro 5 •§, -j *C f° ,f *§ CD 5 s- ^ ? . re 1 CO / s ° S ^ cj ^»* ® *Ü s co > s ro S L *a Co *> 2 00 2* ? CO -^ -c== * «:= fe New roseolsR. s? ll - = - °= ^ - -E 7 *? J Hiore marked enlargement, 4? „ — ?* of </),« snle.en. w **. -C ** s» o* - = *? ;»? -* **- *? ,„5* » > CS ^^ 01 ^2. O Z M „-* 5^ 01 ,-5 ^ 00 <T en < , | 1 en S Co 2 w1 <D Z* w appears between the two sexes, the greater number usually appearsin the latter. 362 TYPHOID FEVER. In Hamburg the following figures
RM2AG62TJ–. Selected monographs, comprising Albuminuria in health and disease. ..?i 1. Left kidney. 2. Right kidney. 3. Left renal vein kinked and twisted. 4. Right renal vein compressed. 5. Ureter. 6. Abdominal aorta. 7. Vena cava inferior. Tliere are, perhaps^ few pathological processes which havebeen so accurately investigated as the coarser disturbancesof circulation in the renal vein. Max Hermann and Ludioig(i 14) found that after tying the renal vein the tubuli uriniferibecame completely closed in consequence of the obstructionto the return of the blood, so that the secretion of urineceased. If th
RM2AKG8J3–Typhoid fever and typhus fever . uring the initial stage, and at theheight of the fever, whether the case bemild or severe, the skin is almost always riG-hot and dry. Only in very rare cases,where the initial rise of temperature is followed by a marked remissionlasting several days, is sweating occasionally observed. During the fall by crisis the skin is usually more or less moist;rarely, there may be profuse sweating. The occurrence of the latter isdistinctly more common in lethal cases about the time of the ominousfall in the temperature. The offensive or even specific odor of the perspirati
RM2AKG9RB–Typhoid fever and typhus fever . CO 4^ CO CO cn CO CO c» CO o 4=- ro 4^ CO 4^ in T** ^r 4r a> X- the almost intermittent forms of fever (Figs. 38 and 39). The periodof onset, entirely like that of the primary attack, is usually charac-terized by step-like or characteristic steep curves (Figs. 36 and 37). 352 TYPHOID FEVER. Termination of the relapse by critical decline is relatively rare. Agradnal; entirely uncharacteristic decline, with an irregular, often pro-tracted course, or subsidence with marked intermissions, is more fre-quent ; this occurs again especially in cases in which also th
RM2AKG7FA–Typhoid fever and typhus fever . ::::*:;:: V:::::::::::::::::M -- »-- - .--- ---- -i ^ 5*N>. ^ *? * w i ^ *•«-. T1 n T X ^ - . * --T ^ - £ s / -^ V f ^ 3 3- £ ---- ± 5 -* ä- -t v it **-t 5 - *>,- i J 7— -- — - s r ^ =F i s | 1 -S1BS-I 1 1 1 fully described, I will give three temperature-charts with short notes of thecorresponding case histories. The first case (Fig. 70) was that of a feeble old man, sixty-three yearsof age, who for months before he was taken ill had lived amid the mostdestitute circumstances. His illness began with a series of slight chill
RM2AG6494–. Selected monographs, comprising Albuminuria in health and disease. Relations of the Kidneys to aJjacent organs. The anterior surface, in the foetus lobed, in the adultsmooth, convex, directed a little forwards and outwards, iscovered by the peritoneum in its whole extent. On the rigidside two-thirds or thi*ee-fourths, or sometimes even the wholeof the kidney lies beneath the liver and therefore to a greateror less extent beneath the ascending colon or hepatic flexureof the colon (flexura coli dextia), aud more or less close to Incorrectly quoted by Landau.—Tbanslatob. MOVEABLE KIDNEY JN WOME
RM2AKG8YT–Typhoid fever and typhus fever . *???» Ss., it. EP -2* .. -*-- e—L ro P- t S» w C* =--« N % ^ :> » »P M §» Wl ?c ro % .-s». OB *n -*--= **- N> S ?-—«l ,I=* r ^ 3- ro *? ---3s oo 1 - sS-- M H i-MT m F±±sH J It ® i-i k *:;? co o c CO UQ f > ?* c? l 4*= CO B I ^ to ^t c CO <t CO <. ^5 ^ •r 5«^ <^ CO Wj i^ 1 £ f GO •d y a o ^5- ?O X «£». CO CD . ^i > 00 2± 4 co H J J CO P ^ £ /* © . ? V *? P >l ^ 4> •n > Ro m §J *• T-( ^> to •o § *- CD ^**»- ^ *• t) 5 *? 5 r Ol CD j* *? w ^^fc. X £> p — C51 ä^**». *• ?si tn * ?r *** CJl ? — — — * S™* ???-? C35 ? •a*™™
RM2AKG8RK–Typhoid fever and typhus fever . rvescence strikingly recalls what occurs during theinitial stage. The abruptness and rapidity with which the fever risesare usually paralleled by the completeness with which the temperaturefalls to or below the normal within a few hours or days. It is not atall a rare occurrence for the temperature to fall at one drop, usuallyduring the night, from a considerable height—40° and above—to 37°or even less (Fig. 53). More frequently this fall is interrupted by atemporary rise in the curve, the temperature at first sinking to 38.5°or 38°, and then, toward evening, m
![. Selected monographs, comprising Albuminuria in health and disease. 7; B. Stiller, Wiener med. Wochcnscbr., 1880, Nos. 18, 19. (99) Klebs, Patb. Anat., ii, S. 644 ; Salvioli, Arcbivio per le sc. mod., 1879, iii; Cobnbeim, 1. c, ii, S. 320!!; Fricdlander, Verbdlg. der pbysiol.Ges. zu Berlin, 1880, Novbr. 19 ; Eibbert, Nepbritis u. Albuminurie. ]2G LITEEATUKE DEFERRED TO. (lOo) Cohnheim, 1. c, ii, S. 434 ff. (loi) Gull 11. Sutton, Med.-Chir. Transact., Iv, 1872, May 28; Senator, Ver- handl. der Berliner med. Gcs., 1880, Mai 12.(102) Posner, I.e., S. 323, Anm. EXPLANATION OF THE ENGPtAVlNG. Sect Stock Photo](https://c8.alamy.com/comp/2AG6536/selected-monographs-comprising-albuminuria-in-health-and-disease-7-b-stiller-wiener-med-wochcnscbr-1880-nos-18-19-99-klebs-patb-anat-ii-s-644-salvioli-arcbivio-per-le-sc-mod-1879-iii-cobnbeim-1-c-ii-s-320!!-fricdlander-verbdlg-der-pbysiolges-zu-berlin-1880-novbr-19-eibbert-nepbritis-u-albuminurie-2g-liteeatuke-deferred-to-loo-cohnheim-1-c-ii-s-434-ff-loi-gull-11-sutton-med-chir-transact-iv-1872-may-28-senator-ver-handl-der-berliner-med-gcs-1880-mai-12102-posner-ie-s-323-anm-explanation-of-the-engptavlng-sect-2AG6536.jpg ". Selected monographs, comprising Albuminuria in health and disease. 7; B. Stiller, Wiener med. Wochcnscbr., 1880, Nos. 18, 19. (99) Klebs, Patb. Anat., ii, S. 644 ; Salvioli, Arcbivio per le sc. mod., 1879, iii; Cobnbeim, 1. c, ii, S. 320!!; Fricdlander, Verbdlg. der pbysiol.Ges. zu Berlin, 1880, Novbr. 19 ; Eibbert, Nepbritis u. Albuminurie. ]2G LITEEATUKE DEFERRED TO. (lOo) Cohnheim, 1. c, ii, S. 434 ff. (loi) Gull 11. Sutton, Med.-Chir. Transact., Iv, 1872, May 28; Senator, Ver- handl. der Berliner med. Gcs., 1880, Mai 12.(102) Posner, I.e., S. 323, Anm. EXPLANATION OF THE ENGPtAVlNG. Sect Stock Photo")
RM2AG6536–. Selected monographs, comprising Albuminuria in health and disease. 7; B. Stiller, Wiener med. Wochcnscbr., 1880, Nos. 18, 19. (99) Klebs, Patb. Anat., ii, S. 644 ; Salvioli, Arcbivio per le sc. mod., 1879, iii; Cobnbeim, 1. c, ii, S. 320!!; Fricdlander, Verbdlg. der pbysiol.Ges. zu Berlin, 1880, Novbr. 19 ; Eibbert, Nepbritis u. Albuminurie. ]2G LITEEATUKE DEFERRED TO. (lOo) Cohnheim, 1. c, ii, S. 434 ff. (loi) Gull 11. Sutton, Med.-Chir. Transact., Iv, 1872, May 28; Senator, Ver- handl. der Berliner med. Gcs., 1880, Mai 12.(102) Posner, I.e., S. 323, Anm. EXPLANATION OF THE ENGPtAVlNG. Sect
RM2AGAA6G–. Selected monographs. 1. Left l«clney. 2. Itight kidiifjy. 3. Lett renal veiu kiuked and twisted. 4. Right reniil vein compressed. 5. Ureter. 6. Abdominal aorta. 7. Vena cava inferior. There are, perhaps^ few patliological processes whicli havebeen so accurately investigated as the coarser disturbancesof circulation in the renal vein. Max Hermann and Ludioig(114) found that after tying the renal vein the tubuli uriniferibecame completely closed in consequence of the obstructionto the return of the blood, so that the secretion of urineceased. If the renal vein became pervious again, the secre-
RM2AKGB1W–Typhoid fever and typhus fever . ons. This premonitory character of the temperature in the face of animpending relapse is almost always associated with a similar peculiarityof the pulse. It is likely under such circumstances, in spite of per-fectly quiet, careful behavior on the part of the patient, to exhibit, inaddition to relatively great frequency, more frequent and unusuallymarked fluctuations. If a large number of curves from cases of relapse are analyzed, itwill be observed—as appears to me not to have been sufficiently empha-sized heretofore—that in the majority this peculiar premonito
RM2AGABPW–. Selected monographs. iovs of the Kidneys io culjdccht orr/ans. The anterior surface, in the fretus lobed, in the adultsmooth, convex, directed a little forwards and outwards, iscovered by the peritoneum iu its whole extent. On the rlr/Jitside two-thirds or three-fourtlis, or sometimes even the wholeof the kidney lies beneath tlie liver and therefore to a greateror less extent beneath the ascending colon or hepatic flexureof the colon (flexura coli dextra), and more or less close to THCorrectly quoted by Landau.—Tbanslatob. MOVEABLE KIDNEY JN WOMEN. 239 tlie vertical portion of tlie duodenum
RM2AKGD3M–Typhoid fever and typhus fever . for nine days, the markedly remit-tent and intermittent curve rising generally in the evening to from 39° to39.7° C, and finally exhibiting a peculiar and rare variety of critical declinein two stages. Between the ninth and the tenth day the temperature fellfrom 39° to 37° C, then fluctuated for two days between 37° and 37.6° C, todecline again suddenly below normal between the eleventh and twelfth days,and persisting at this low level during the first part of convalescence (Fig.29). As the temperature-chart shows, the pulse in this case was from theoutset unus
RM2AGACET–. Selected monographs. Stiller, Wiener med. Wochenschr., 1880, Nos. 18, 19. (99) Klöbs, Path. Anat., ii, S. 644 ; Salvioli, Archivio per le sc. med., 1879, iii; Cohnheim, 1. c, ii, S. 320 ff; Friedländer, Verhdlg. der pliysiol.Ges. zu Berlin, 1880, Novbr. 19 ; Ribbert, Nephritis u. Albuminurie. 126 LITEEATUßE EEFERRED TO. (loo) Colinlielin, 1. c, ii, S. 434 ff- (loi) Gull u. Sutton, Med.-Chir. Transact., Iv, i872,May.2S; Senator, Ver- handl. der Berliner med. Ges., 1880, Mai 12.(102) Posner, I.e., S. 323, Anm. EXPLANATION OF THE ENGRAVING. Section of rabbits kidney hardened by boiling and alco
RM2AKG8EE–Typhoid fever and typhus fever . ases willbe observed in which thedisease runs its course inthe usual time—from four-teen to seventeen days, oreven longer—without oncemanifesting an unusuallyhigh temperature. These mild cases gener-ally do not begin with adistinct chill. After aperiod during which thepatient complains of chillyfeelings, the temperaturerises gradually, by succes-sive steps, so that it maynot reach its ultimateheight before the fourthday of the disease. Ac-cordingly, the initial symp-toms—headache, backache,vomiting, etc.—are alsoless severe, and in manypatients the mind remains
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