Archives of Internal Medicine

ROSENOW, EDWARD C.

doi: 10.1001/archinte.1933.00150220002001pmid: N/A

Abstract One of the reasons why the importance of streptococci in the etiology of rheumatic fever and various other forms of arthritis, especially chronic infectious arthritis, is not sufficiently recognized is the fact that bacteriologists have been too much concerned with differences in cultural reactions and not enough with the peculiar infecting power of the streptococci isolated, especially immediately after isolation. The diseases comprising the arthritic group, generally considered as being due to streptococci, are so different in their clinical and pathologic manifestations, and the cultural properties of streptococci are so variable,1 that the requirements stressed by some2 that all streptococci isolated must have identical cultural reactions to be of significance is fallacious. In a long series of experiments, I have shown that the streptococci isolated in cases of rheumatic fever3 and chronic infectious arthritis,4 irrespective of whether they are green-producing, indifferent or slightly hemolytic, possess on References 1. Rosenow, E. C.: Transmutations Within the Streptococcus-Pneumococcus Group , J. Infect. Dis. 14:1 ( (Jan.) ) 1914.Crossref 2. Todd, E. W.: The Conversion of Hemolytic Streptococci to Non-Hemolytic Forms , J. Exper. Med. 48:493 ( (Oct.) ) 1928.Crossref 3. Birkhaug. K. E.: Rheumatic Fever. Bacteriologic Studies of a Non-Methemoglobin-Forming Streptococcus with Special Reference to Its Soluble Toxin Production , J. Infect. Dis. 40:549, 1927.Crossref 4. Clawson, B. J.: Studies on the Etiology of Acute Rheumatic Fever , J. Infect. Dis. 36:444, 1925.Crossref 5. Small, J. C.: The Bacterium Causing Rheumatic Fever and a Preliminary Account of the Therapeutic Action of Its Specific Antiserum , Am. J. M. Sc. 173:101 ( (Jan.) ) 1927.Crossref 6. Swift, H. F.; Derick, C. L., and Hitchcock, C. H.: Rheumatic Fever as a Manifestation of Hypersensitiveness (Allergy or Hyperergy) to Streptococci , Tr. A. Am. Physicians 43:192, 1928. 7. Rosenow, E. C.: The Etiology of Acute Rheumatism, Articular and Muscular , J. Infect. Dis. 14:61 ( (Jan.) ) 1914.Crossref 8. Rosenow, E. C.: Etiology of Arthritis Deformans, Preliminary Note , J. A. M. A. 62:1146 ( (April 11) ) 1914.Crossref 9. Rosenow, E. C.: The Newer Bacteriology of Various Infections as Determined by Special Methods , J. A. M. A. 63:903 ( (Sept. 12) ) 1914.Crossref 10. Cecil, R. L.; Nicholls, Edith E., and Stainsby, W. J.: Bacteriology of the Blood and Joints in Rheumatic Fever , J. Exper. Med. 50:617 ( (Nov.) ) 1929.Crossref 11. Rosenow, E. C.: (a) Focal Infection and Elective Localization , Internat. Clin. 2:29 ( (June) ) 1930 12. footnotes 4 and 5. 13. Rosenow, E. C.: Serologic Specificity of Streptococci Having Elective Localizing Power as Isolated in Various Diseases of Man , J. Infect. Dis. 45:331, 1929.Crossref 14. Valentine, Eugenia, and Van Meter, Martha: The Localization of Streptococci in the Tissues of Rabbits , J. Infect. Dis. 47:56, 1930.Crossref 15. Margolis, H. M., and Dorsey, Anna H. E.: Chronic Arthritis; Bacteriology of Affected Tissues , Arch. Int. Med. 46:121 ( (July) ) 1930.Crossref 16. Rosenow (footnotes 4 and 5.) 17. Rosenow, E. C., and Nickel, A. C.: Results in Various Diseases from Elimination of Foci of Infection and Use of Vaccine Prepared from Streptococci Having Elective Localizing Power , J. Lab. & Clin. Med. 14:504 ( (March) ) 1929. 18. Cecil, R. L.; Nicholls, Edith E., and Stainsby, W. J.: The Bacteriology of the Blood and Joints in Chronic Infectious Arthritis , Arch. Int. Med. 43:571 ( (May) ) 1929 19. footnote 6. 20. Haden, R. L.: The Elective Localization of Bacteria in Peptic Ulcer , Arch. Int. Med. 35:457 ( (April) ) 1925. 21. Meisser, J. G., and Brock, Sam: A Clinical and Experimental Study in Chronic Arthritis , J. Am. Dent. A. 10:1100 ( (Dec.) ) 1923. 22. Moench, L. Mary: The Relationship of Chronic Endocervicitis to Focal Infection with Special Reference to Chronic Arthritis , J. Lab. & Clin. Med. 9:289 ( (Feb.) ) 1924. 23. Nakamura, T.: A Study on Focal Infection and Elective Localization in Ulcer of the Stomach and in Arthritis , Ann. Surg. 79:29 ( (Jan.) ) 1924. 24. Nickel, A. C.: The Localization in Animals of Bacteria Isolated from Foci of Infection , J. A. M. A. 87:1117 ( (Oct. 2) ) 1926.Crossref 25. Rosenow (footnotes 4, 5 and 7). 26. Rosenow, E. C., and Ashby, Winifred: Focal Infection and Elective Localization in the Etiology of Myositis , Arch. Int. Med. 28:274 ( (Sept.) ) 1921.Crossref 27. Valentine and Van Meter (footnote 9). 28. Rosenow, E. C., and Jensen, L. B.: Elective Localization and Cataphoretic Potential of Streptococci. Preliminary Report , Proc. Soc. Exper. Biol. & Med. 27:442, 1930. 29. Crowe, H. W.: Bacteriology and Surgery of Chronic Arthritis and Rheumatism with End-Results of Treatment , New York, Oxford University Press, 1927.

KOLMER, JOHN A.

doi: 10.1001/archinte.1933.00150220021002pmid: N/A

Abstract The frequency of the chronic intractable bronchitides, extensive bronchiectasia and other nontuberculous suppurative infections of the bronchi and lungs commonly grouped under the designation of suppurative pneumonitis, along with the well established fact that ordinary medicinal treatment possesses little or no real value, renders this relatively large group of pulmonary infections worthy of further investigation in relation to both etiology and treatment. This is particularly true since bronchiectasis not unfrequently begins in childhood and sometimes results in semi-invalidism for many years and indeed for the balance of life. Fortunately, bronchoscopic drainage and bronchial lavage have definitely improved the treatment and prognosis of bronchiectasis and these allied conditions. Bronchoscopic drainage, as developed by the brilliant investigations of Jackson, Tucker, Clerf and others, has at least largely aided in the treatment in those cases due to foreign bodies1 and, along with bronchography, has greatly improved methods of diagnosis as well as References 1. Jackson, C.: Suppurative Diseases of the Lung Due to Inspirated Foreign Body Contrasted with Those of Other Etiology , Surg., Gynec. & Obst. 42:305, 1926. 2. Stitt, H. L.: Bronchial Aspiration and Irrigation with a Hypertonic Saline Solution , J. Med. 8:112, 1927. 3. Iglauer, S.: Advantages of Intubation Method of Introducing Iodized Oil for Bronchography in Children , J. A. M. A. 97:1517 ( (Nov. 21) ) 1931. 4. Smith, D. T.: Relation of Vincent's Angina to Fusospirochetal Disease of the Lungs , J. A. M. A. 94:23 ( (Jan. 4) ) 1930. 5. Alexander, J., and Buckingham, W. W.: Treatment of Nontuberculous Suppurative Pneumonitis, Abscess and Bronchiectasis , J. A. M. A. 95:1478 ( (Nov. 15) ) 1930. 6. Castex, M. R.; Heidenreich, A. J., and Repetto, R. L.: Le salvarsan par voie trachéale dans le traitement des Processes fétides de l'appareil respiratoire , Bull. Acad. de méd., Paris 95:131 ( (Feb. 9) ) 1926. 7. Stiehm, R. H.: Treatment of Bronchiectasis with Lipoidol with Report of Nineteen Cases , Wisconsin M. J. 29:556, 1930. 8. Ballon, R. H., and Ballon, H. C.: The Value of Bronchoscopic Injections of Lipoidol in the Diagnosis and Treatment of Bronchiectasis , J. Laryng. & Otol. 44:153, 1929. 9. Kolmer, J. A.: Bismuth Arsphenamine Sulphonate (Bismarsen) in the Treatment of Syphilis and of Other Spirochetic Infections , Arch. Dermat. & Syph. 21:394 ( (March) ) 1930. 10. Dunning, F., and Farinholt, L. H.: J. Am. Chem. Soc. 51:804, 1929. 11. Drake, W. E., and Dunning, F.: Organic Antiseptics: Bacteriologic Study of a New Series , J. Infect. Dis. 48:366 ( (April) ) 1931. 12. Macht, D. I., and Cook, H. M.: Pharmacology and Toxicology of Monohydroxy-Mercuri-Di-Iodo-Resorcin-Sulphonphthalein , J. Pharmacol. & Exper. Therap. 43:571, 1931. 13. Akatsu, S.: The Resistance of Spirochetes to the Action of Hexamethylenetetramine Derivatives and Mercurial and Arsenic Compounds , J. Exper. Med. 25:363, 1917. 14. Kolmer, J. A.: Principles and Practice of Chemotherapy with Special Reference to the Treatment of Syphilis , Philadelphia, W. B. Saunders Company, 1926, p. 342. 15. Sato, T.: Ueber den pathologisch-histologischen Einfluss des Lipoidols und die bakterizide Wirkung desselben , Mitt. ü. allg. Path. u. path. Anat. 5:183, 1929.

KARSNER, HOWARD T.

doi: 10.1001/archinte.1933.00150220042003pmid: N/A

Abstract Syphilis may affect the pulmonary artery as a productive-cicatricial lesion like that form common in the aorta, the so-called Döhle-Heller type; it may occur as a gummatous arteritis, or it may be manifested simply by the formation of gummas. Warthin further accepted as syphilitic a form of diffuse arteritis which affects principally the smaller vessels. Neither he nor Brüning, Thorel, Henschen or Rogers, all of whom he quoted in support of this view, offered definite or convincing proof. The conclusions of these investigators were arrived at by probability, exclusion or belief, based occasionally on the finding of syphilitic lesions elsewhere in the body. In spite of Peck's excellent critique of the matter, the recent report of a case by Hare and Ross is based on the presence only of suspicious lesions in the systemic aorta. These authors quoted Thomas in support of their conclusion, but many of Thomas' cases did References 1. Von Glahn has the protocol of an unpublished case in the records of the Department of Pathology , Columbia University, New York. 2. The morphologic diagnosis is as certain in the pulmonary artery as in the aorta. With his skill and excellent technic Warthin was able to demonstrate spirochetes, but in the other cases they have not been found. In the present case the demonstration failed, but the morphologic evidence is so definite as to leave no doubt of the diagnosis. 3. Balaban, J. J., and Pokydow, M. J.: Zur Diagnostik der Aneurysmen der Lungenarterie , Röntgenpraxis 1:454, 1929. 4. Barth, H.: Ein Fall von Mesarteritis luetica der Arteria pulmonalis mit Aneurysmenbildung , Frankfurt. Ztschr. f. Path. 5:139, 1910. 5. Brenner, O.: Sclerosis of the Pulmonary Artery with Thrombosis , Lancet 1:911, 1931.Crossref 6. Daly, I. deB.: The Resistance of the Pulmonary Vascular Bed , J. Physiol. 49: 238, 1930. 7. Darré, H., and Albot, G.: Une forme de syphilis du poumon: sclérose syphilitique nodulaire avec panartérite pulmonaire , Ann. d'anat. path. 5:861, 1928. 8. Frothingham, C.: A Case of Extensive Bilateral Progressive Thrombosis of the Smaller Branches of the Pulmonary Artery , Am. J. Path. 5:11, 1929. 9. Gibbon, J. H.; Hopkinson, M., and Churchill, E. D.: Changes in Circulation Produced in Gradual Occlusion of the Pulmonary Artery , J. Clin. Investigation 11:543, 1932.Crossref 10. Hare, D. C., and Ross, J. M.: Syphilitic Disease of the Pulmonary Arteries, with Account of a Case , Lancet 2:806, 1929.Crossref 11. Henschen, S. E.: Das Aneurysma arteriae pulmonalis , Samml. klin. Vortr. , 1906, no. (422-423) 12. Inn. Med. no. (126-127) , 595-655 13. Jump, H. D., and Baumann, F.: Large Thrombus of the Pulmonary Artery with Chronic Cyanosis and Polycythemia , Pennsylvania M. J. 32:754, 1929. 14. Karsner, H. T.: Pulmonary Arteries , in Survey on Arteriosclerosis , Josiah Macy, Jr., Foundation, to be published. 15. Letulle, M., and Jacquelin, A.: Anévrismes syphilitiques de l'artère pulmonaire , Arch. d. mal. du cœur 13:385, 1920. 16. Means, J. H., and Mallory, T. B.: Total Occlusion of the Right Branch of the Pulmonary Artery by an Organized Thrombus , Ann. Int. Med. 5:417, 1931.Crossref 17. Moritz, A. R.: Syphilitic Coronary Arteritis , Arch. Path. 11:44 ( (Jan.) ) 1931. 18. Okkels, H., and Thierkelsen, F.: Ein Fall von Atherosklerosis pulmonalis mit Aneurysma Arteria pulmonalis bei offenstehen des Foramen ovale , Acta path. et microbiol. Scandinav. 9:214, 1932.Crossref 19. Peck, S.: Pathologic Anatomy of Syphilis of the Pulmonary Artery: Report of a Case and Review of the Literature , Arch. Path. 4:365 ( (Sept.) ) 1927. 20. Plenge, K.: Zur Frage der Syphilis der Lungenschlagader , Virchows Arch. f. path. Anat. 275:572, 1930.Crossref 21. Ploeger, A.: Das Aneurysma der Arteria pulmonalis , Frankfurt. Ztschr. f. Path. 4:286, 1910. 22. Posselt, A.: Die Erkrankungen der Lungenschlagader , Ergebn. d. allg. Path. u. path. Anat. 13:298, 1909. 23. Reeke, T.: Ueber Syphilis der Pulmonalarterie , Centralbl. f. allg. Path. u. path. Anat. 49:257, 1930. 24. Rogers, L.: Extensive Atheroma and Dilatation of the Pulmonary Arteries, Without Marked Vascular Lesions, as a Not Very Rare Cause of Fatal Cardiac Disease in Bengal , Quart. J. Med. 2:1, 1908-1909.Crossref 25. Rosenthal, S. R.: Sclerosis of the Pulmonary Artery and Arterioles , Arch. Path. 10:717 ( (Nov.) ) 1930. 26. Sindoni, M.: Sulla sifilide dell'arteria pulmonare , Arch. ital. di anat. e istol. path. 1:629, 1930. 27. Thomas, M.: Contribution à l'étude des affections acquises de l'artère pulmonaire, Thèse de Paris, 1927. 28. Vogl, A.: Ein Fall von luischem Aneurysma der Arteria pulmonalis , Med. Klin. 27:1352, 1931. 29. Warthin, A. S.: Syphilis of the Pulmonary Artery , Am. J. Syph. 1:693, 1917.

NATHANSON, M. H.

doi: 10.1001/archinte.1933.00150220062004pmid: N/A

Abstract In 1866 Czermack1 demonstrated that digital pressure of the neck in the region of the vagus nerve caused a slowing of the heart rate in man. He attributed this effect to a mechanical excitation of the vagus nerve. Hering,2 while making observations on this phenomenon, noted that very slight pressure resulted in marked cardiac inhibition in some instances. These observations led him to doubt the theory of direct vagal stimulation. Hering and his co-workers demonstrated conclusively that the slowing of the heart by digital pressure in the neck was the result of a reflex which originated in a specialized portion of the internal carotid artery, the carotid sinus. It has been observed that the usual response to pressure on the carotid sinus is a moderate slowing of the heart rate, but that in some instances there results a complete arrest of the heart for many seconds. The present References 1. Czermack, J. N.: Ueber mechanische Vagusreizung beim Menschen, Jenaische , Ztschr. f. med. u. Naturw. 2:384, 1866. 2. Hering, H. E.: Die Karotissinus-Reflexe auf Herz und Gefässe, Dresden, Theodore Steinkopff, 1927. 3. Rothberger, C. J., and Winterberg, H.: Ueber die experimentalle Erzeugung extrasystolischer ventrikulärer Tachykardie durch Accelleransreizung , Arch. f. d. ges. Physiol. 142:461, 1911.Crossref 4. Hering, H. E.: Ueber die unmittelbare Wirkung des Accellerans und Vagus auf automatisch-schlagende Abschnitte des Säugetierherzen , Arch. f. d. ges. Physiol. 108:281, 1905.Crossref 5. Cullis, W. E., and Tribe, E. M.: Distribution of Nerves in the Heart , J. Physiol. 46:141, 1913. 6. Luckhardt, A. B., and Koppanyi, T.: Studies on the Hemodynamic Action of Subcutaneously Injected Epinephrine , Am. J. Physiol. 81:436, 1927. 7. Gradinesco, A.: Différence d'action entre l'éphédrine et l'adrénaline , Compt. rend. Soc. de biol. 96:1027, 1927. 8. Bain, W. A.: Action of Adrenaline and of Certain Drugs on the Isolated Crustacean Heart , Quart. J. Exper. Physiol. 19:297, 1929. 9. La Barre, J.: Existe-t-il une syncope éphédrino-chloroformique , Compt. rend. Soc. de biol. 98:863, 1928. 10. Wilson, C. P.; Pilcher, C., and Harrison, T. R.: The Effect of Drugs on Cardiac Output; Effect of Ephedrine on Minute Cardiac Output of Normal Dogs , Arch. Int. Med. 41:622 ( (May) ) 1928.Crossref 11. Chen, K. K., and Schmidt, C. F.: The Action of Ephedrine, the Active Principle of the Chinese Drug, Ma Huang , J. Pharmacol. & Exper. Therap. 24:339, 1924. 12. Miller, T. G.: A Consideration of the Clinical Value of Ephedrine , Am. J. M. Sc. 170:157, 1925. 13. Rowntree, L. G., and Brown, G. E.: Ephedrine Therapy in Addison's Disease , Endocrinology 10:301, 1926. 14. Rudolph, R. D., and Graham, J. D.: Notes on Sulphate of Ephedrine , Am. J. M. Sc. 173:399, 1927. 15. Middleton, W. S., and Chen, K. K.: Ephedrine, a Clinical Study , Arch. Int. Med. 39:385 ( (March) ) 1927. 16. Fahr, George: Personal communication. 17. Hollingsworth, M.: Ephedrine in Adams-Stokes Syndrome , California & West. Med. 26:802, 1927. 18. Stecher, R. M.: A Note on Adams-Stokes Disease Treated with Ephedrine , Am. Heart J. 3:567, 1928. 19. Wood, J. E., Jr.: Ephedrine in Adams-Stokes Syndrome , J. A. M. A. 98:1364 ( (April 16) ) 1932. 20. von Egmond, A. A. J.: Ueber die Wirkung einiger Arzneimittel beim volständigen Herzblock , Arch. f. d. ges. Physiol. 154:39, 1913. 21. Wilson, F. N., and Hermann, G. R.: Some Unusual Disturbances of the Mechanism of the Heart Beat , Arch. Int. Med. 31:923 ( (June) ) 1923. 22. Cohn, A. E., and Levine, S. A.: The Beneficial Effects of Barium Chloride on Adams-Stokes Disease , Arch. Int. Med. 36:1 ( (July) ) 1925. 23. Parsonnet, A. E., and Hyman, A. S.: Barium Chloride in Stokes-Adams Syndrome of Complete Heart Block , Am. J. M. Sc. 180:356, 1930.Crossref 24. Wenckebach, K. F.: The Effects of Digitalis on the Human Heart , Brit. M. J. 2:1600, 1910. 25. Rothberger, C. J., and Winterberg, H.: Ueber die Einfluss von Strophanthin auf die Reizbildungsfähigkeit der automatischen Zentren des Herzens , Arch. f. d. ges. Physiol. 150:217, 1913.Crossref 26. Robinson, G. C., and Wilson, F. N.: A Quantitative Study of the Effects of Digitalis on the Heart of the Cat , J. Pharmacol. & Exper. Therap. 10:491, 1918. 27. Gold, H.; Hitzig, W.; Gelfand, B., and Glassman, H.: A Qualitative Comparison of Various Digitalis Bodies , Am. Heart J. 6:237, 1930. 28. Sollmann, T.: A Manual of Pharmacology , ed. 4, Philadelphia, W. B. Saunders Company, 1932, p. 280. 29. Hirschfelder, A. D.: Diseases of the Heart and Aorta , ed. 3, Philadelphia, J. B. Lippincott Company, 1918, p. 587.

SOKOLOFF, MARTIN J.;STEWART, HAROLD L.

doi: 10.1001/archinte.1933.00150220078005pmid: N/A

Abstract Sclerosis of the pulmonary artery and arterioles associated with Ayerza's syndrome occurs secondary to a variety of diseases, congenital and acquired, of the heart, lungs, pericardium, pleura and blood vessels (Miller1). Primary sclerosis developing independently of these conditions is much less frequent. The majority of the latter cases are due to syphilis (Rogers,2 Warthin,3 Arrillaga,4 Elizalda,5 Hare and Ross,6 Thomas,7 Bruce and co-workers,8 Cheney,9 Weber and Bode10 and Konstam and Turnbull11); a few to rheumatic fever (Paul12). In a smaller group the lesion is hyperplastic and noninflammatory and the etiology obscure (Rosenthal,13 Bacon and Apfelbach14). REPORT OF CASE G. P., a stevedore, white, aged 48, was first seen in October, 1924, complaining of a cough productive of a small amount of mucus, a feeling of constriction across the upper part of the chest and dyspnea, which had developed over a period of five years. The family References 1. Miller, H. R.: M. Clin. North America 9:673, 1925. 2. Rogers, L.: Quart. J. Med. 2:1, 1908.Crossref 3. Warthin, A. S., in Contributions to Medical and Biological Research , New York, Paul B. Hoeber, Inc., 1919, vol. 2, p. 1042. 4. Arrillaga, F. C.: Monograph on Cardiacos Negros , Buenos Aires, 1925. 5. Elizalda, P., quoted by Escudero, P.: Arch. d. mal. du cœur 19:439, 1926. 6. Hare, D. C., and Ross, J. M.: Lancet 2:806, 1929.Crossref 7. Thomas, Marcel: Thèse de Paris, 1929, no. 474. 8. Bruce, J. D.; Wilson, F. N.; Hickey, P. M.; Coller, F. A., and Warthin, A. S.: Ann. Clin. Med. 5:9, 1926. 9. Cheney, G.: Am. J. M. Sc. 174:34, 1927.Crossref 10. Weber, F. P.: Brit. M. J. 2:658, 1920Crossref 11. Polycythemia, Erythrocytosis and Erythremia , London, H. K. Lewis & Co., Ltd., 1921. 12. Weber, F. P., and Bode, O. B.: Polycythemia, Erythrocytosis and Erythremia , London, H. K. Lewis & Co., Ltd., 1929. 13. Konstam, G. L. S., and Turnbull, H. M.: Lancet 2:756, 1929.Crossref 14. Paul, J. R.: Lesions in the Pulmonary Artery in Rheumatism , Arch. Path. 3:354 ( (Feb.) ) 1927. 15. Rosenthal, S. R.: Sclerosis of the Pulmonary Artery and Arterioles , Arch. Path. 10:717 ( (Nov.) ) 1930. 16. Bacon, C. M., and Apfelbach, C. W.: Tr. Chicago Path. Soc. 12:293, 1924-1927. 17. McCann, William S., and Stephens, D. J.: Tr. Am. Climat. & Clin. A. 47:3, 1931. 18. Pappenheimer, A. M., and Von Glahn, W. C.: Am. J. Path. 2:15, 1926. 19. Moon, V. H., and Stewart, H. L.: Experimental Rheumatic Lesions in Dogs and in Rabbits , Arch. Path. 11:190 ( (Feb.) ) 1931. 20. Shaw, R. Cunliff: Quart. J. Med. 19:203, 1926. 21. Pearce, R. M.: Bull. Johns Hopkins Hosp. 17:94, 1906. 22. Palenttini, D. B.: Arch. per le sc. med. 43:63, 1920. 23. Moschowitz, Eli: Am. J. M. Sc. 174:388, 1927. 24. Christopher, F.: Ann. Surg. 90:394, 1929. 25. Stapford, J. S. B.: Lancet 1:465, 1918. 26. Todd, T. W.: J. Nerv. & Ment. Dis. 40:439, 1913 27. Anat. Rec. 8:243, 1914 28. J. Anat. & Physiol. 47:250, 1913. 29. Schaeffer, J. P.: Pennsylvania M. J. 34:786, 1931. 30. Manouelian, Y.: Ann. Inst. Pasteur 27:14, 1913. 31. Evans, G.: Quart. J. Med. 14:215, 1920. 32. Fishberg, A. M.: Anatomic Findings in Essential Hypertension , Arch. Int. Med. 35:650 ( (May) ) 1925. 33. Kernohan, J. W.; Anderson, E. W., and Keith, N. M.: The Arterioles in Cases of Hypertension , Arch. Int. Med. 44:395 ( (Sept.) ) 1929. 34. Jores, L.: Wesen und Entwickelung der Arteriosklerose , Munich, J. F. Bergmann, 1903. 35. Yater, W. M., and Konstam, G. R.: M. Clin. North America 12:1689, 1929. 36. Posselt, A.: Ergebn. d. allg. Path. u. path. Anat. 13:398, 1909 37. Wien. Arch. f. inn. Med. 11:357, 1925. 38. Saunders, W. E.: Primary Pulmonary Arteriosclerosis with Hypertrophy of the Right Ventricle , Arch. Int. Med. 3:257 ( (April) ) 1909. 39. Giroux, Leon: Arch. d. mal. du cœur 3:595, 1910. 40. Veale, P. J., and Coombs, C.: Brit. J. Child. Dis. 12:72, 1915. 41. Eppinger, H., and Wagner, R.: Arch. f. inn. Med. 1:83, 1920. 42. Mattirolo, G.: Arch. per le sc. med. 44:124, 1921. 43. Gamna, C.: Pathologica 13:207, 1921. 44. Romberg: Deutsches Arch. f. klin. Med. 48:197, 1891. 45. Aust, C.: München. med. Wchnschr. 39:689, 1892. 46. Monckeberg, J. G.: Verhandl. d. deutsch. path. Gesellsch. 14:173, 1909. 47. Huber, H. L., and Koessler, K. K.: The Pathology of Bronchial Asthma , Arch. Int. Med. 30:689 ( (Dec.) ) 1922.Crossref 48. Bertelli, Falta and Schwerger: Ztschr. f. klin. Med. 71:23, 1910. 49. Eppinger, H., and Hess, L.: Vagotonie , Berlin, A. Hirschwald, 1910, p. 60. 50. Pescatori, F.: Riv. di path. e clin. d. tuberc. 4:735, 1930. 51. Winternitz, M. C.; Smith, G. H., and McNamara, F. P.: J. Exper. Med. 32:205, 1920.Crossref 52. Boyd, William: Pathology of Internal Diseases , Philadelphia, Lea & Febiger, 1931, p. 137. 53. Kidd, P.: Tr. Clin. Soc., London 37:192, 1904 54. Clark, R. C.; Coombs, C. F.; Hatfield, G., and Todd, A. T.: Quart. J. Med. 21:51, 1928. 55. Loubry, W., and Thomas, M.: Bull. et mém. Soc. méd. d. hôp. de Paris 51:9, 1927.

SMITH, DAVID T.;McCONKEY, M.

doi: 10.1001/archinte.1933.00150220088006pmid: N/A

Abstract The etiology of peptic ulcer in man is unknown. Heredity, occupation, infections, tobacco, alcohol, worry and trauma of the mucous membrane from hot foods have been suggested as etiologic factors, but are inadequate explanations. The relation of vitamins to tuberculous ulceration of the intestine as demonstrated in our previous studies1 suggested that peptic ulcer might be due to a deficiency of certain vitamins in the dietary. HISTORIC REVIEW The following data also suggest that peptic ulcer may be related to the dietary. The incidence of peptic ulcer varies in different countries: 0.8 per cent in Russia, 1.3 per cent in North America, 5 per cent in England and Germany and 16 per cent in Denmark. A marked increase in the incidence of peptic ulcer occurred in Russia and Germany during the period of partial starvation which followed the World War (from 1914 to 1918).2 Hutter3 stated that References 1. McConkey, M.: Treatment of Intestinal Tuberculosis with Cod Liver Oil and Tomato Juice , Nat. Tuberc. A. Tr. 25:105 ( (May) ) 1929. 2. Smith, D. T., and McConkey, M.: Experimental Intestinal Tuberculosis in the Guinea-Pig Induced by Feeding Tubercle Bacilli to Animals Living on a Diet Deficient in Vitamins , Nat. Tuberc. A. Tr. 25:627 ( (May) ) 1929. 3. Cecil, Russell L.: A Textbook of Medicine , Philadelphia, W. B. Saunders Company, 1930, p. 688. 4. Hutter, K.: Seasonal Variations in Occurrence of Gastric and Duodenal Ulcers , J. A. M. A. 91:2030 ( (Dec. 22) ) 1928. 5. Holt, Luther Emmett: Diseases of Infancy and Childhood , ed. 12, New York, D. Appleton and Company, 1923, p. 337. 6. Rosenow, Edward C.: Etiology of Spontaneous Ulcer of Stomach in Domestic Animals , J. Infect. Dis. 32:384 ( (May) ) 1923.Crossref 7. Ivy, A. C.: Studies on Gastric Ulcer , Arch. Int. Med. 25:6 ( (Jan.) ) 1920.Crossref 8. Underhill, F. P., and Mendel, L. B.: A Dietary Deficiency Canine Disease , Am. J. Physiol. 83:589, 1928. 9. Smith, Theobald: Investigation of Diseases of Domestic Animals, U. S. Dept. Agric., Bur. Animal Industry , Ann. Rep. 12 and 13, 1895, p. 171. 10. Holst, Axel, and Frölich, Theodor: Experimental Studies Relating to Ship Beri-Beri and Scurvy , J. Hyg. 7:634, 1907.Crossref 11. McCarrison, Robert: Studies in Deficiency Disease , New York, Oxford University Press, 1921, p. 95. 12. McCarrison, Robert: Some Surgical Aspects of Faulty Nutrition , Lancet 1:1151 ( (May 23) ) 1931.Crossref 13. Hess, A. E.: Scurvy, Past and Present , Philadelphia, J. B. Lippincott Company, 1920. 14. Magee, H. E.; Anderson, W., and McCallum, J.: Diet and Peptic Ulcer in Cavies , Lancet 1:12 ( (Jan. 5) ) 1929.Crossref 15. Jackson, Leila, and Moore, J. J.: Studies in Experimental Scurvy in Guinea Pigs , J. Infect. Dis. 19:478, 1916.Crossref 16. McCollum, E. V., and Pitz, W.: Vitamin Hypothesis and Deficiency , J. Biol. Chem. 30:229, 1917. 17. Cohen, B., and Mendel, L. B.: Experimental Scurvy of the Guinea Pig in Relation to the Diet , J. Biol. Chem. 35:425, 1918. 18. Sherman, LaMer and Campbell: Quantitative Determination of the Antiscorbutic Vitamin C , J. Am. Chem. Soc. 44:165 ( (Jan.) ) 1922.Crossref 19. McCarrison (footnotes 10 and 11).

STEWART, SLOAN G.

doi: 10.1001/archinte.1933.00150220102007pmid: N/A

Abstract Inherent sensitivity of the skin to nickel, in contrast to the acquired form, which has been found so frequently among those who work with nickel, seldom has been described. Allusions are made, however, to a "natural" susceptibility among certain workers, especially blond people and young women. Indeed, a real distinction may be made between inherent and acquired sensitivity of the skin to external sensitizing agents. In that group in which sensitiveness to nickel is acquired are placed those cases of "irritative dermatitis" in which, by repeated contact of the skin with solutions of nickel salts or finely divided particles of nickel dust, an eruption develops at the site of exposure. This does not imply a latent sensitivity, for after a certain period of exposure this lesion may develop under certain conditions of heat and moisture in any person exposed for a sufficiently long period. Quite analogous is the experiment described by References 1. Walthard, B.: Die Erzeugung experimenteller Nickelidiosynkrasie bei Laboratoriumstieren , Schweiz. med. Wchnschr. 56:603, 1926. 2. Blaschko, A.: Die Berufsdermatosen der Arbeiter , Deutsche med. Wchnschr. 15:925, 1889.Crossref 3. White, R. P.: The Dermatergoses or Occupational Affections of the Skin , ed. 3, London, H. K. Lewis & Co., 1928. 4. Blumer, F. M. R., and Mackenzie, E. A.: Studies in the Control and Treatment of "Nickel Rash," J. Indust. Hyg. 8:517, 1926. 5. Gron, K.: Nickelplater's Rash , Urol. & Cutan. Rev. 33:606, 1929. 6. McAlester, A. W., Jr., and McAlester, A. W., 3d: Nickel Sensitization from White Gold Spectacle Frames , Am. J. Ophth. 14:925, 1931. 7. Lain, E. S.: Nickel Dermatitis , J. A. M. A. 96:771 ( (March 7) ) 1931. 8. Rothman, S.: Hypersensitiveness to Metal Coins , J. A. M. A. 97:336 ( (Aug. 1) ) 1931. 9. Jadassohn, J.: Hautkrankheiten bei Stoffwechselanomalien , Fifth Internat. Dermat. Cong. 1904, vol. 2, p. 231. 10. Schoch, A. G.: Arsphenamine Sensitization Tests Including a Report of Arsenical Dermatitis Due to Arsenobenzol Radical of Bismarsen , Am. J. Syph. 14:75, 1930. 11. Lewith: Verhandl. Dermat. Gesellsch. d. Tschechoslowakô Republic , (Feb. 18) , 1927 12. Kesten, B., and Laszlo, E.: Dermatitis Due to Sensitization to Contact Substances; Dermatitis Venenata, Occupational Dermatitis , Arch. Dermat. & Syph. 23:221 ( (Feb.) ) 1931. 13. Pemberton, R.: A Summary of the Effects of External Heat Upon the Human Body , Am. J. M. Sc. 169:485, 1925. 14. Schittenhelm, A., and Stockinger, W.: Ueber die Idiosynkrasie gegen Nickel und ihre Beziehung zur Anaphylaxie , Ztschr. f. d. ges. exper. Med. 45:58, 1925.

SUTLIFF, WHEELAN D.;FINLAND, MAXWELL;HUNNICUTT, THOMAS N.

doi: 10.1001/archinte.1933.00150220110008pmid: N/A

Abstract It has been suggested that the effects of specific serum therapy in type I lobar pneumonia are due, not to the specific antibodies contained in the serum, but to the nonspecific action of the intravenously administered horse serum proteins. Miller1 and von den Velden,2 as well as Hallermann and Kähler,3 have made this suggestion because of the symptomatic changes they noted in lobar pneumonia following the injection of protein materials other than immune horse serum, such as typhoid vaccine, normal horse serum and normal human serum. Sonnenfeld4 and Lichtenstein5 have supported this suggestion because they occasionally observed striking clinical improvement in patients with pneumonia due to pneumococci other than type I following the administration of serum that presumably contained only type I pneumococcic antibodies. An examination of the question from the point of view of those who have had extended experience with the specific serum, References 1. Miller, J. L.: The Present Status of Nonspecific Therapy , J. A. M. A. 95:464 ( (Aug. 16) ) 1930.Crossref 2. von den Velden, R.: Klinisch-experimentelle Beiträge zur Kenntnis temperatur-herabsetzender Substanzen , Deutsches Arch. f. klin. Med. 113:324, 1913-1914. 3. Hallermann, A., and Kähler, H.: Ueber die Typeneinteilung der Pneumonie und ihre Behandlung mit Serum , Klin. Wchnschr. 9:650, 1930.Crossref 4. Sonnenfeld, A.: Serumtherapie der kruppösen Pneumonie , Deutsche med. Wchnschr. 56:569, 1930.Crossref 5. Lichtenstein, Hermann: Die Serumbehandlung der croupösen Pneumonie , Med. Klin. 25:1966, 1929. 6. Neufeld, F., and Haendel, L.: Weitere Untersuchungen über Pneumokokken-heilsera: III Mitteilung. Ueber Vorkommen und Bedeutung atypischer Varietäten des Pneumokokkus , Arb. a. d. k. Gsndhtsamte. 34:293, 1910. 7. Cecil, R. L., and Blake, F. G.: Studies on Experimental Pneumonia: VII. Treatment of Experimental Pneumococcus Type I Pneumonia in Monkeys with Type I Antipneumococcus Serum , J. Exper. Med. 32:1, 1920.Crossref 8. Goodner, Kenneth: Further Experiments with the Intradermal Pneumococcus Infection in Rabbits , J. Exper. Med. 48:413, 1928.Crossref 9. Howard, Campbell P.: The Diagnosis and Treatment of Pneumonia , Oxford Monographs on Diagnosis and Treatment , New York, Oxford University Press, 1931, vol. 10. 10. Sutliff, W. D., and Finland, M.: Type I Lobar Pneumonia Treated with Concentrated Pneumococcic Antibody (Felton) , J. A. M. A. 96:1465 ( (May 2) ) 1931.Crossref 11. Felton, L. D.: The Concentration of Antipneumococcus Serum , J. A. M. A. 94:1893 ( (June 14) ) 1930.Crossref 12. Goodner, Kenneth: Experiments on the Concentration of Antipneumococcic and Antimeningococcic Horse Serum . J. Immunol. 19:473, 1930. 13. Hiss, P. H., and Zinsser, Hans: Experimental and Clinical Studies on the Curative Action of Leukocyte Extracts in Infections , J. M. Research 14:321, 1908. 14. Klemperer, G.: Kritischer Bericht über Zwanzig Fälle spezifisch behandelter Pneumonie , Wien. med. Wchnschr. 42:882, 1892. 15. Neufeld, F., and Händel, L.: Ueber Herstellung und Prüfung von Antipneumokokkenserum und über die Aussichten einer spezifischen Behandlung der Pneumonie , Ztschr. f. Immunitätsforsch. u. exper. Therap. 3:159, 1909. 16. Goldsborough, Brice W.: A Contribution to the Treatment of Pneumonia with Antipneumococcic Serum , J. A. M. A. 38:1681 ( (June 28) ) 1902.Crossref 17. Weitz, W.: Ueber die Behandlung der Pneumonie mit intravenösen Injektionen des Neufeld-Händelschen Pneumokokkenserums , Med. Klin. 8:1072, 1912. 18. Reuss, A.: Beiträge zur Behandlung der Pneumonie mit dem Neufeld-Händelschen Pneumokokkenserum , Deutsche med. Wchnschr. 40:1104, 1914.Crossref 19. Géronne, A.: Die Behandlung der Pneumonie mit dem Neufeld-Händelschen Pneumokokkenserum , Berl. klin. Wchnschr. 49:1699, 1912. 20. Weill-Hallé, B.; Weissman-Netter, R., and Aris, P.: Pneumonies et broncho-pneumonies des vieillards, traitées par le serum antipneumococcique , Bull. et mém. Soc. méd. d. hôp. de Paris 46:227, 1922. 21. d'Oelsnitz, Duplay and Carcopino: La sérothérapie des pneumopathies aigues . Bull. et mém. Soc. méd. d. hôp. de Paris 46:588, 1922. 22. Courcoux and Deglaire: Traitement des pneumopathies aigues a penumocoques par la sérothérapie , Bull. et mém. Soc. méd. d. hôp. de Paris 46:248, 1922. 23. Etienne, G., and Braun, M.: Sérothérapie antipneumococcique , Bull. et mém. Soc. méd. d. hôp. de Paris 47:1813, 1923. 24. Lassance, V.: Le traitement de la pneumonie par le sérum antipneumococcique , Presse méd. 27:30, 1919. 25. Cecil, R. L., and Sutliff, W. D.: The Treatment of Lobar Pneumonia with Concentrated Antipneumococcus Serum , J. A. M. A. 91:2035 ( (Dec. 29) ) 1928.Crossref 26. Finland, M.: The Serum Treatment of Lobar Pneumonia , New England J. Med. 202:1244, 1930.Crossref 27. Park, W. H.; Bullowa, J. G. M., and Rosenblüth, M. B.: The Treatment of Lobar Pneumonia with Refined Specific Antibacterial Serum , J. A. M. A. 91: 1503 ( (Nov. 17) ) 1928.Crossref 28. Kolchin, Betty S., and Gross, Louis: Observations on the Cross-Protective Power of Antipneumococcus Monovalent Sera, Types I, II, and III , J. Immunol. 9:505, 1924. 29. Sutliff, W. D.: An Investigation of the Reliability of Sputum Typing for Pneumococcus by Mouse Method , J. Infect. Dis. 42:485 ( (May) ) 1928.Crossref 30. Petersen, W. F.: Protein Therapy and Non-Specific Resistance , New York, The Macmillan Company, 1922. 31. Zinsser, Hans: Resistance to Infectious Disease , ed. 4, New York, The Macmillan Company, 1931, p. 470. 32. Weichardt, W.: Unspecifische Immunisierung , in Kolle, W.; Kraus, R., und Uhlenhuth, P.: Handbuch der pathogenen Mikroorganismen , ed. 3, Jena, Gustav Fischer, 1931, vol. 1, p. 1147.

HAYMAN, J. M.;BENDER, J. A.

doi: 10.1001/archinte.1933.00150220122009pmid: N/A

Abstract Since the time of Bright, albuminuria has commonly been associated with disease of the kidneys. More recently the distinction has been made between non-nephritic and nephritic albuminuria. The former is most readily attributed to a transient and reversible increase in permeability of the glomerular membrane from partial asphyxia brought about by circulatory changes.1 From time to time, however, the suggestion has been made that nephritic albuminuria is the result of changes in the plasma proteins rather than any change in or damage to the kidney itself. Epstein2 saw in the albuminuria of nephrosis a disturbance of plasma protein formation; Kollert and Starlinger3 an increased tissue destruction leading to increase in fibrinogen; and Munk and his associates,4 an abnormality in the physicochemical state of the plasma colloids. The conception of extrarenal albuminuria is supported by the appearance of foreign proteins, such as egg albumin, in the urine References 1. Starr, Isaac, Jr.: The Production of Albuminuria by Renal Vasoconstriction in Animals and Man , J. Exper. Med. 43:31 ( (Jan.) ) 1926.Crossref 2. Epstein, A. A.: Thyroid Therapy and Thyroid Tolerance in Chronic Nephrosis , J. A. M. A. 87:913 ( (Sept. 18) ) 1926.Crossref 3. Kollert, V., and Starlinger, W.: Ueber das Verteilungsverhältnis der Eiweisskörpergruppen des Blutplasmas und Harnes bei Nierenkranken , Ztschr. f. klin. Med. 104:44, 1926. 4. Munk, F.; Benatt, A., and Flockenhaus, M.: Experimentelle Untersuchungen über das Wesen der Albuminurie und der Lipoidnephrose , Klin. Wchnschr. 4:863 ( (April 30) ) 1925.Crossref 5. Hamburger, F.: Zur Frage der Immunisierung gegen Eiweiss , Wien. klin. Wchnschr. 15:1188, 1902. 6. Garnier, M., and Schulmann, E.: Sur l'albuminurie déterminée par l'injection de blanc d'oeuf au lapin , Compt. rend. Soc. de biol. 93:600 ( (July 25) ) 1925. 7. Andrews, E.: Experimental Uremia , Arch. Int. Med. 40:548 ( (Oct.) ) 1927.Crossref 8. Andrews, E., and Thomas, W. A.: The Origin of Urinary Proteins , J. A. M. A. 90:539 ( (Feb. 18) ) 1928.Crossref 9. Andrews, E.; Thomas, W. A., and Welker, W. F.: Albuminuria in the Mechanism of Detoxification , Arch. Int. Med. 43:139 ( (Jan.) ) 1929.Crossref 10. The kidneys grossly showed no distinct reduction in size but slight pitting of the surface. They were principally the seat of passive hyperemia. Microscopically, the capsule was absent. The surface showed numerous areas of depression at the base of which was a triangular area of fibrosis with lymphoid cell infiltration. The elevated portions showed small cystlike dilatations of the tubules. The connective tissue generally was slightly increased in amount and moderately edematous. The tubular epithelium and the subcapsular epithelium showed advanced cloudy swelling. Fat stains showed well marked fatty degeneration in both situations. Polarizing prisms failed to disclose anisotropic droplets. A few hyaline casts were present. The large and medium-sized arteries showed moderate intimal fibrosis. The small arteries showed marked intimal and medial fibrosis with only slight fatty changes. The arterioles in some places showed thick and fibrotic walls, but with only slight fatty changes. The glomeruli varied greatly in size, but those that were not markedly fibrotic were unusually large. Fibrosis attacked both the capsule and the tuft, and in numerous instances there was complete replacement of glomeruli by fibrous and fibrohyaline material. The larger tufts showed well marked lobulation and many blood-containing loops, appeared to be richly cellular and often showed adhesions between the tuft and the capsule. Variable degrees of fibrosis with slight hyaline change were found in the tufts, and occasionally a loop was completely hyalinized. The Azan-Carmine stain of McGregor showed considerable thickening of the basement membrane with only a few areas in which it was wrinkled. There were, then, severe chronic arterial and moderate arteriolar lesions, glomerular changes that were somewhat more like those of inflammatory than like those of arteriolar disease and a marked simple nephrotic component evident in the advanced cloudy swelling and fatty degeneration of the tubules. 11. Shevky, M. C., and Stafford, D. D.: A Clinical Method for the Estimation of Protein in Urine and Other Body Fluids , Arch. Int. Med. 32:222 ( (Aug.) ) 1923.Crossref 12. Schmid, J.: Ueber den Ausscheidungsort von Eiweiss in der Niere , Arch. f. exper. Path. u. Pharmakol. 53:419, 1905.Crossref 13. del Baere, L. J.: Die Ursache der Albuminurie bei der Nephrose , Ztschr. f. d. ges. exper. Med. 79:743, 1931.Crossref 14. Gaebler, O. H.: Diffusibility of the Proteins of Normal and Pathological Plasma , J. Biol. Chem. 93:467 ( (Oct.) ) 1931. 15. Rusznyak, S., and Nemeth, L.: Die Entstehung der Albuminurie , Ztschr. f. d. ges. exper. Med. 70:464, 1930.Crossref 16. Volhard, F.: Nieren und ableitende Harnwege , in von Bergmann, G., and Staehelin, R.: Handbuch der inneren Medizin , ed. 2, Berlin, Julius Springer, 1931, vol. 6, p. 821.

OSTERMAN, A. L.

doi: 10.1001/archinte.1933.00150220127010pmid: N/A

Abstract Despite characteristic and striking clinical symptoms and a not infrequent occurrence, the syndrome of spontaneous subarachnoid hemorrhage is still largely unrecognized in general practice. This fact, together with the recent observation of a case of spontaneous subarachnoid hemorrhage, has prompted a brief review of the present status of the subject and a report of the case at hand. Subarachnoid hemorrhage, like jaundice or pruritus, is merely a symptomatic expression of some more fundamental pathologic state. Subarachnoid hemorrhage as a coincidental sign may be found in a variety of pathologic conditions. It may occur in trauma directed to the skull or vertebral column, as in fracture or dislocation, when vessels are ruptured and blood is extravasated into the subarachnoid space. It may occur in acute or chronic inflammatory processes in the meninges or encephalon, as in meningococcic, syphilitic or tuberculous meningitides or in epidemic and hemorrhagic encephalitides (vaccinia, smallpox and measles). References 1. Ohler, W. R., and Hurwitz, D.: Spontaneous Subarachnoid Hemorrhage , J. A. M. A. 93:1856 ( (May 28) ) 1932.Crossref 2. Wilson, G., and McIver, J.: Spontaneous Subarachnoid Hemorrhage , J. A. M. A. 93:89 ( (July 13) ) 1929.Crossref 3. Leopold, S. S.: Spontaneous Subarachnoid Hemorrhage , M. Clin. North America 13:869 ( (Jan.) ) 1930. 4. Leopold, S.: Subarachnoid Hemorrhage , J. A. M. A. 63:1363 ( (Oct. 17) ) 1914. 5. Smith, W. A.: Spontaneous Subarachnoid Hemorrhage , South. M. J. 23: 494 ( (June) ) 1930.Crossref 6. Sands, J.: Subarachnoid Hemorrhage as a Clinical Complication of Neurosyphilis , Arch. Neurol. & Psychiat. 24:85 ( (July) ) 1930.