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Image from page 721 of “Endocrinology” (1917)
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Identifier: endocrinology07asso
Title: Endocrinology
Year: 1917 (1910s)
Authors: Association for the Study of Internal Secretions (U.S.) Endocrine Society
Subjects: Endocrinology Endocrinology
Publisher: Los Angeles, Calif. : Association for the Study of Internal Secretions
Contributing Library: Gerstein – University of Toronto
Digitizing Sponsor: University of Toronto
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ichI reported a year ago illustrates this point, and it seems wellat this time to review briefly several other cases of this typein order to emphasize a problem that the physician meets in hisdaily practice, to point a way toward its solution, and to inter-pret the laboratory findings in each ease. JOHN 701 Case No. 1: A married woman, 66 years of age, came to theclinic complaining of rheumatism. The family history was negative.She had had grippe and rheumatism and sciatica 6 weeks before thisconsultation. For the last 8 months she had had frequency of urina-tion but no loss of weight and no thirst. She had always been fondof sweets and had eaten them freely. The routine examinationshowed sugar in the urine. Eixamination of the blood showed inmg./lOO cc, blood sugar, 113; urea, 22.9; chlorides, 574. A glucosetolerance test was made with the findings given in the table andgraphically shown in Chart I, which demonstrate that this is a caseof glycosuria in a non-diabetic subject. ^m*hr ^
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Case No. 2: A single woman, aged 22 years, came for a consul-tation because of increasmg weight, having gained 20 pounds duringthe preceding 2 months. Her family history was negative. She had haddiphtheria, scarlet fever, pneumonia, grippe and tonsilitis; she com-plained of a weak spell every afternoon when things became blurrybefore her eyes, of feeling dopy and of sleeping a great deal.During the preceding 6 months she had had dribbling of the urine,but at the time of consultation thought she was passing more urine.She suffered from occipital headaches, and a coarse tremor of thehands. The Wassermann test was negative, spinal fluid negative,x-ray of sella turcica negative. The result of the glucose tolerancetest is shown in the table and in Chart II. Joslin and others have called attention to the importanceof watching for diabetes in fat people. Whenever I see a middleaged fat patient, I always wonder whether the adiposity be-tokens a beginning diabetes or whether it is merely a nor
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Image from page 774 of “American practice of surgery ; a complete system of the science and art of surgery” (1906)
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Identifier: americanpractic07brya
Title: American practice of surgery ; a complete system of the science and art of surgery
Year: 1906 (1900s)
Authors: Bryant, Joseph D. (Joseph Decatur), 1845-1914, ed Buck, Albert H. (Albert Henry), 1842-1922
Subjects: Surgery
Publisher: New York, W. Wood and company
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons
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period of time,the length of which is difficult to determine. In the small bowel the symptoms SURGICAL DISEASES OF THE IXTESTIXES. 741 are more obscure than in the large bowel. If the disease is located in the duo-denum the symptoms may simulate tliuse of cholelithiasis. There may bemerely indefinite, so-called dyspeptic symptoms for some time; in fact, so longas the fecal cunvnt is not intcrfcivd with, symptoms may be entirely lacking.In chronic intestinal stenosis the symi)t()ms may persist for a considerable time.An acute ileus may occur suddenly without warning, or it may follow a chronicstenosis. Alternating constipation and diarrhcea, with the discharge of pusand blood, are very suggestive. A tumor may sometimes be palpable. Painis not a marked sTnptom. When the tumor is situated low down in the boweltenesmus may be present. Xothnagel has called attention to a stiffening of the bowel— Darmsteifung—which is visible in intestinal stenosis. This condition was present in sixty
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Fig. 2S9.—Mesenteric Stitch and Stitch at Convex Border Inserted and Tied, with the Ends LeftLong for Traction. The inter%-ening stitclies are in place. (F. G. Connell.) per cent of ^Mikuliczs cases. Willy ]ileyer has called attention to a contracturewhich is not objectively demonstrable, but is noticed by the patient only. Thesensation, which is not always painftil, is called by him subjective stiffeningof the bowel. He considers it an important point in diagnosing carcinoma ofthe colon. Meteorism is likewise a spiiptom of intestinal stenosis: and acontinuous loss of weight, not necessarily associated with cachexia, leads to asuspicion of cancer. Ascites is usually a late manifestation, occurring afterthe peritoneum has become involved. A slight elevation of temperature (99° or 100° F.) is common in the earlystages of carcinoma, even before there is any ulceration. Progressive loss ofweight, with increasing anaemia, is very common in carcinoma of the bowel.In suspected cases it i
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