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THE STUDY OF MIND IN MEDICAL EDUCATION

THE STUDY OF MIND IN MEDICAL EDUCATION of chemical for their in facts illustrate the difference in the the conditions the growth only virility propitious in situ. natural of the normal between isms disturbance equilibrium organ tissue and themselves. the to from the the causes spirochctes disappear Mercury arc the Some blood, and is therefore against changes necessary safeguard non-syphilitic greatest preliminary the of lesions of The infection. Whether the in ill all late maternal it attacks formation organism syphilis. or doubt the the the marrow where are no harbored seborrheic syphilids, lymph, they palmar Byphilids syphilid, is doubt of be taken as illustrations of this in latent ful. the mouth, syphilis, may To the is observation. me the that latent mother syphilitic theory of which in such is a how else could one cases blood-borne a spiroebete-carrier organisms Syphilis disease; arc the There are now and in (be and secondary lesions? many theories then, blood-stream, likely explain appear, of late dis- to settle at of or dis- lesions—l,evaditi*s physiologic explanatory points pathologic syphilitic all of if not of turbance local Neisser's the phenomena turbance, immunity, Umstimmung, explains many, etc. and also tertiary parental syphilis syphilis. Together anaphylaxis, with the of the lint how reach the areas of this must fact that the do the tertiary go recognition spirochetes a host for must carried the blood, and is an which can inhabit disturbance? be spirochete organism They by is mechanical or influences at a without It in chemical causing disturbance. slop years, interesting through results certain thus cause a lesion of this connection to note the of the observations of anil proliferate, point, in to So it is of and in relation or less with the cancer, more extent. Tyzzer pathogenesis Qaylord spirochetes when that in mice rats a new The woman in all and is, harboring spiroehotes, congenital syphilis. probability, at occurs in filled with the she has in her circulation, it is them, latently general growth frequently syphilitic; free are only tintes, live, which occasionally spirochetes organisms. has culture to her She have Now that a may syphilitic Noguchi proper pathogenic organism. developed in her or a oolonv in hod for the it will he much Scars vessels, met spirochete, probably possibly struggling llu ids arc the circu- easier to demonstrate it in and tissues. bcr aorta. The free carried spirochetes by suspected vessels The of the has been the into the or the testicle rabbit heretofore lation growing placenta, forming best such as of which numerous or abnormal and medium for demonstration, being present possibly cheapest are for. to and At rale. animals too areas them lodge propagate. any higher expensive. but to find in the is tissue with less resistance The are difficult there pla- spirochetes very growing possibly the sides of centa hut cultural methods more seek writers failures, vnsciilarily. mechanically ; many They report the is most fre- be of assistance in a colony formed, and this is will clearing up many vessels; patho- great is that found on the side. conditions. It highly possible embryonic placenta! quentiy logic with Loeb, he the attributed to In this over Dr. Leo in placenta, talking many appearances syphilis, theory Two he carriers to me : factors are not this disease. women the may Pregnant suggested following explanation of be as for the this other besides the greater in spirochete. suggested responsible way organisms may possibly whom of to show lesions. In' are in the the There organism syphilitic spirochcte-earriers liability placenta the the a there arc first mixed is as nieningocoecus being organ, innocuous, typhoid place placenta, partly just is Clinical observations and of of and carriers. origin, only many maternal, probably diphtheria partly embryonal at the of those other lines to a extent influence substances seem, less under along experimental investigations the at least to in infected which cause least, confirm this fact. mother, originating partially a of the maternal lesions. it partial Secondly, 412 immunity Humboldt Building. of is tissues in active thai certain pro- process possible such extent in to liferation differ their cell-metabolism an certain as do not to stimuli thai effectively they respond MIND MEDICAL THE STUDY OF IN do tissues. as functionating quiescent normally EDUCATION ll is ran- lind In the to decidua, extremely spirochetes side. bul are found on the embryonic WILLIAM A. M.D. they frequently WHITE, The various conditions of the placenta depend pathologic D. C. WASHINGTON, in «ni The the location of the colonies. organisms find It a most is that it is the obvious for truism as the best media growth frequently the elsewhere, placenta, nearest at that is overlooked the hand, about vessels. thing, thing the has in and not For the been from a fresh seen. an strain generations physician If syphilis early vigorous arisen and here and there has one of the fetus his is an death will the practicing art, only early parent planted, has considerable to fact becomes who the strain more attenuated any thought as the given plain occur; generally is And while in that man a of the bodies of the under influences immunizing thinking, feeling organism. the learns a the older children or latent good way physician undoubtedly syphilitic practical parent (an syphilis), of to deal with his as he or infection children the empirically patients thinking organ- horn; syphilitic may all be still in of medical education there is that it the fetus from so mild a strain isms, process the be may may of to inculcate this fact into the mind little effort made out the hereditary by immunizing entirely stamped the to to him student, much less endeavor teach about child. influences of the the of the and mind, its the rule of that older functions, It is a standing the organization way clinical long in which it as is reacts to disease he is these the the less likelihood there in the taught things parent, syphilis (hat in the which is fact about fur infection of child, due to the every organ body. Ihe The reason for this lack of of the mental and she Such host less that those appreciation a contains spirochetes. arrive in not to at. We nient how- life is My docs virulent. must easy harbor are less ion, conception altogether the reason is that tremendous that the of the shown inocula- of that Noissor has complexity ever, experimental bus reason course in a human which hallled man's for so run same tions lesions the organism, from tertiary is to to be while others have understand, as from an lesion; many generations only beginning earlier chimpanzee Bhown inoculations from that secondary retrograding Manhattan of Read at a of the Medical New meeting Society These two York lesions variable and uncertain results. March 22, 1012 City, give Downloaded From: http://jama.jamanetwork.com/ by a University of Manitoba User on 06/13/2015 so a fathomed that of unstable his mentality must so that after sufficiently grasp be, although comprehensive all, the has entire loomed on the horizon as an illustration have to be original been up my might problem supposed it when is imminent nnd is svch a com- it not such from sore a far the to possibility only cry finger academic, the is that the of mind clinical of the disordered grasp possible actual, prehensive phenomena practical, problem into at for deal mind. for consideration ia.ll place all, they with the as a it It will seen above whole and therefore be from the organism how primarily simple example after how is its in their interrelations and close, intimate, are the relations between only parts separate existing been the the the have understood that so-called mental and so-called how and problem interdependencias physical, one is of the whole can he when the affected other become approached. easily may involved. I take It is not at this time to enter into that it, all are to admit. This, my object willing of between I.el where much-worn discussion the relations us Bee ¡1 leads a subsisting US, short time a Only ago and mind. I will call attention the fact man came into who to a that I am merely my office, represents body type in have afraid is too com mon. that the the interests of the been He of past physician only complained depres- on the he has at an to centered and that looked the sion, inability work, drowsiness and lack of body from and such individual the of ail- lie ambition, indefinite bad rested purely standpoint physical symptoms, ment. and be exercised be bad bad been to the mountains ; and us a to Let for take the other the seashore; he bad tried in the him- moment, however, solve point problem at and he had had of view and let us look the situation from the self, the advice of he had physicians; been the hands mental rather than from the does of the angle. Why genilo physical through -urinary specialist the inconvenience with no he was who is from and results; convinced thai he was patient suffering pain suffering a. sore for the from some Kind of and he been of consult It niilo-iiitoxication. had finger, instance, physician? will be that is I the hands of said it is because his sore. a who say no, finger through gastro-intestinal specialist, is reason. It is sent him This had been that not the because he is ill at to me. man able to after (ind. mentally not a one. an exhaustive ease. The reason is a mental one and the of slightest kind an physical only examination, in the it will be the man has in his and starches said, linger of in the But, pain apparent deficiency digestion The a and that is the reason he consults that is intestines. looked to be in the patient physical thing physically of I that is not so. The condition, lie had been to his doctors and Again say no, many physician. pain pink does not in the is not a bul rune of them had been to find the reside able mutter finger; physical pain anything a to the with and be mental fact, While the is due him all seemed to obsessed whatever, pain directly they itself is of condition of the the with the some kind of elaborating physical finger, pain purely necessity hypoth- man mind he could esis to a mental If the had no his without of them ever experience. explain Bymptoms any And I reason that have no that the he consults were mental. An hour's talk with again say supposing they pain. the he ill at ease. What this man enabled me to make a clear is that is mentally physician perfectly diagnosis. lie does the for The usual answer will was those mild do him? a of one of manic- typical physician example be that ailment. This is true; Im I that we the he cures the know name of physical depressive psychoses by in so a means to the end of true he had he is It is that certain doing only cyclothymia. physical employing mind at rest. He was the After the individual's Bomewhat symptoms. troubled with putting patient's constipa- then he no suffers tion for and I mind is satisfied lie is as recall was the that about well; longer it, example, there suffers from the that of he he no that did ; knowledge only physical any consequence pain longer symptom is on his and he is have. He had found mil a at. that body, brisk disagreeable-looking place by taking good cause be felt and it is the of his Cathartics better, on BUCll a true, peace because, physical occasionally has a of been been removed. basis auto-into.xiciition had theory flimsy suffering elected his Some that this result is in mind. And so we have hen- a case is that by dealing say accomplished mental in its the I certain a case, all for with admit that doing things mistaken by absolutely features, finger. and this but I insist thai a condition treated as such in of the to the one result, spile finger produces physical results so far as to find any real the ultimate the comfort and to take produced, inability tangible physical thing of are hold of! the are mental well-being patient concerned, the that the Then we a of cases that of results and that are in have class nil sorts changes develo)) wrought of are to of about such a disturbances after slight errors the end bringing gastro-intestinal very finger only effmts I admit that I have taken an diet, or after or with- mental condition. will as moderate involving fatigue, ¡Ilús- an extreme in older 1 out cause we bave a certain instance that might any apparent upset physical example the the hut us is focalized in the trale of view from menial let that svstem, and point angle; gaslro-intestinal little and with the are treated in or diet- a further examine, the aid of these one bv way proceed patients another, matters a lo and ! the end of or crucial lest; of all medical, case that came rest, and behold two ing, by by observation three we have bands a limlei' some time since. years we find on our developing my of a sore and it is that case of dementia nnd we learn cases that It was the case for such prsecox, by finger, such 1 it here. A man had nol the out- reason that introduce precede frank young Bymptoms infrequently his it break of the and so we (ind of what wounded one of and was back fingers, infected. again psychosis, slightly surface are There of the on the a mental condition was a inclosed in single pus physical drop symptoms perhaps serious of far more and overlooked. and there was a rise infected usually slight tempera* territory, Then we have a host invalids 99 hut man was whole of neurasthenic as I recall about the F.; young ture, it, who have with of in some trouble them: a tbe and delirious. What now becomes of the sore ovary. bed, cyst of a a in this situation? The tbe uterus, chronic floating and .its appendicitis, finger problem prolapse general of other and as info as an and all sorts as the a is sunk days Conditions, finger insignificance, kidney, finger except and months to much the themselves mit index to the the much more into larger, go by drag years point way The these a toward of the individual. infection is reaction their patients develop physical important, problem which is of 01 measures the out all to the luit a barometer thai the resistance of malady degree proportion are a tremendous and one of a the itself. with mentality, drop pus, temper- malady They building patient's of structure of disordered mind on small foundation of 99 F. and one can see how a ature seriously delirium, Downloaded From: http://jama.jamanetwork.com/ by a University of Manitoba User on 06/13/2015 and do have that the actual cost of the although something remembering maintenance of physical ailment, they the with them is matter still the the individual the smallest physically physical thing single of probably portion to feature in cost to has since ceased be the the his real the he be if a long important community, especially if work and the to a miracle and the head of a case, attempts wage-earner physician family. and cure over out an these old The next class to that has be considered in people night, by taking great this or a a connection consists — or neph- of the idiots and imbeciles appendix indi- performing ventro-BUspension he will have of his serious dis- viduals whose one is ropcxy, professional again inefficiency the 'result of plainly not retire mental and and will he disease defect, Then a only conies considerable appointments ultimately front the tie-field beulen and bal but he will class of of are whom defi- chagrined, deaf-mutes, many mentally also most the fail What is the cient: while we are more, know so. hopelessly. patient epileptics generally better instead of will be for the Aside from these classes arc worse, that conceded b> being throughout generally builded certain have on this a to the field mental of there are they physical thing belong medicine the years of and the attitude of the who structure are not to hope physician may paupers, in generally supposed belong them believe this after have made that when it was removed but what, is class; but an they all, pauperism would be when of this to come to to in the all fails after pass inability get world, and whai, is well; along all, are an to into the intricacies of their in the mental world but a they plunged deeper inability get along Ihe menial And here we see the of with of of the tangle. again inability, course, importance exception, relatively mental element. And on cases of the so I few disablement? might go interminably physical illustration after illustration. Then, one who with any has bad considerable again, any I have said about which. I the criminal with classes knows nothing hysteria, may that experience prac- in is a the mention I have entire of pure only the criminal is a mental psychosis* tically problem passing, intimated field the the existence of the tremendous of while such social as problem, questions prostitution and I have that not mentioned again themselves under the same very group general category. psychoneuroses, of the the so-called I could on of all of these huge group psychoses, give state- symptomatic example example and mental conditions that disease in ments, but the limited of such a as bodily this accompany space paper of is infections. Not all those il are various The recent work only with (lie groups quite impossible. juvenile menial eases from the of medicine however, has delinquent, all of these important standpoint emphasized points in the but it is that attention and Over over large, again. extremely important to as fall mid- this work be addressed them, because it has also were, shown that they, Fortunately many between the fields of of the internist and defective mentally children are so only way operation apparently do the not come within the because of removable defects. Here is a psychiatrist. They purview physical boy, of in their earlier the least manifesta- for ai who is mentally all psychiatrist, example, defective; apparently heed while the internist little to them because he needs is an adenoid Here is another who tions, pays operation. he is not so a of a studv and field medicine, is and it would interested, irritable, seem tremendously really of not to is if which could fail be as he be a neglected murderer when he The enlightening, might grows up. because of this situation. whole is a is which correctihlc. purely practical difficulty myopia readily In various cases of mental to On the other a reviewing the groups here is defective four or hand, girl, which 1 but directed have I think one attention, five behind There is a casually years who psychologically. girl it cannot fail to see that no small number. will a become or a or Now comprises both. is prostitute criminal, While I not to subscribe to the statement to am the time tackle the of prepared whether she will or not.' problem of one of at a medical that friends recent meeting The of my and of have problems criminality prostitution disease of is most been social one these neuroses alone the common as far back as the of man problems history in all I if be still think' that the matter and has been the made to medicine, given goes, solve attempt always it be conceded at careful will that it is least them the by with but one can thought finished dealing product, c\dc< as to or nol this of diseases im more debatable whether make an on wait- these group impression problems by real not as or more, in finit until time than one can the of much, center produce perhaps suffering ing change the than the and of diseases the has been do for earth. Man to it community physical injuries. gravity trying into 1 bold to So. without more detail make thousands of and he is where he started. entering years, just believe that is clear. What is use of the until this for my point waiting girl, example, all truths before us T With these return to the a original shall have become and shall have infected prostitute, that the of medical education statement innumerable brilliant and during period young men, perhaps promis- im or at least no attention, is wiih lo their is attention, systematic ruin. It too ing, syphilis, everlasting to the mind same addressed in like the laic when has is when degree that occurred. 'Pbe time she anything now. of that to of is devoted the consideration is a so 1 and on afb-r thoroughness child, for might go indefinitely, one of the even the brain itself, and the •any organs, ramifications and the bodily nil, tremendous for importance if that I have ask. these been things mentioning repre- the of the state of as these such well-being problems I believe sent an of and a cases, make lot of the of group they activities medicine important sanitary general not now consideration do. is the time for such look a deal like a in beside them seriousness. why ripe good joke in the médical One be what curriculum? now. T may wondering advocate perhaps, us a at of in the of Let further, and some the of mental step glance way study conditions in the go just the are to social and that usually considered he medical T a course of advocate svs- problems college—-whether see the what mental medicine has on them. To tematic and and the like. T shall bearing laboratory psychology not call attention. what great of the insane I need not discuss and what not to be group ought ought taught It thai the in is evident within domain the of we they belong whether shall quite way psychology investigate of I if we ever the of and make mental medicine. the wonder, however, stop student problems go perception to think the ¡mínense of of of économie their a scries with the importance through laboratory experiences There are over insane taken or we problem. 180,(1(10 whether shall him a lot being of tachistoscopc, give at pare of in the institutions of this association to his country puzzle brains. Those are public experiments in present. Think that means dollars and matters of detail. The what main is to cents, thing acknowledge Downloaded From: http://jama.jamanetwork.com/ by a University of Manitoba User on 06/13/2015 to the at of the other confine itself to abnormal of least as much the on psy- knowledge hand, necessity do of as on in order to it. It take its illustrations structure and the mind is insisted may workings chology the and T of It reference to one of think from field mental however, with any activity. should, any organ body, is of in its trends and be the same kind of the most fundamental he humanistic knowledge prominently primarily reaction times. a of motives rather of I have the student who leaves bis than would psychology importance. no of I not a reaction times has to on medicine do that of medical enter the say practice psychology college It, a of the that all but it is refinement realize his are of them has, psychology thinking, feeling patients place. to medical and not a and the which is of the student that human mind itself much advantage beings, comports for such of a a like the of the much like any organs psychology. body, living precondition wliieb I like to call I have know bow is The last few of would him it built years psychiatry, organism. up, have suffi- the about the somewhat of its structure and its Renaissance necessity brought mechanisms, period, kind of I of for the advocate a so its as he that he psychology ciently may psychology appreciate phenomena and human and would human motives, much of it will them manifested in the and I beings very sec sick-room, he called a him of Ibe iniiinr- might common-sense have understand the more readily psychology operation the which not lite or erudition of the result of does learning tant and that are mechanisms require processes to understand its prin- disease. laboratory investigator general If Ihe human is looked on as a neces- mind reacting I think I have said to demonstrate the ciples. enough of defense and reactions of some Conn of in connection compen- developing sity organism psychologic teaching as the and sation with medical I some develops compensations éducation; add precisely body might systematic defenses of the obscure inaiii- In otherwise dust he 1 am not many form, what the details should disease, going of the mind can la- The fcslalitiiis disordered to to I wniii to draw certain explained. attention suggest. merely curve with disease a A deal that is hip develops compensatory broad now patient general great principles. of (he that, his center of is not so disturbed. than as is more nor less spine gravity taught psychology really nothing lo The with antibodies the antag- and he in connection with diphtheria develops could patient physiology taught onize the and so tbe with menial course in for as the toxins, patient Such invading example, physiology. things, to a are disease us series of reactions that color fields presents of the sense organs, perception, physiology in There character. are two defensive and of taste and of and smell, differentiation compensatory vision, hearing for in Government the — the to Hospital etc. all these be added the patients to-day sensations, might haptic Both them have Insane who have committed of murder. in course physiology. is the killed not, the delusion that is person they I want Io the old- The main that combat developed thing in II, does not fact dead. recondite any and delusion require psy- fashioned, time-honored widely accepted to bow the of such a understand a of the chology development that it is to have full necessary understanding to in of delusion enables them live peace before the comparative so-called normal human mind the of study them from mind. The delusion defends the reality; mind is entered This is human on. delusion diseased oilers for the their them a psychosis compensation on two fallacies. The first is the based fallacy gross and arrows forl tine." of "slings outrageous is as normal mind, that there such a human any thing look the is to on beginning to-day psychosis lias been Psychiatry or at least that such differentiated any thing of as a but as an the of not disease, type expression so we know what it is. The that psychologists may reaction to inimical conditions. The of the individual mind have never told us what the normal certainly not the delusion is the outward delusion is the disease; it can to and what he consisted of. advantage possible the the that is of process expression repair process select combinations of mental out of the kaleidoscopic to about anil balance in the bring harmony elements and label endeavoring one certain arrangement particular so he at mental that live may peace make-up of other patient's it normal and maintain that, none the arrange- at with The not himself. least, psychosis, infrequently, that one is be until ments thoroughly may investigated from is the resort of the individual a world of in reality understood is Secondly, why beyond my comprehension. builds which cannot, live. by means he The up. patient that in to thesis order under- should the be maintained wliieb it; an artificial world to of his delusional system, select for we should the certain mechanisms stand study is which can live. to himself—in be these are possible adapt which most machine in mechanisms complex which I have is the kind of This, is at briefly illustrated, machine at a time when that working represented, with which Ihe student should enter for college of and psychology its perfection, pur- highest efficiency degree his be able mi life-work. He should to see the operation is it not a more of As a matter of fact, poses study? in the of motives his to mechanisms understand of lake either a attitude mind to patients, reasonable simpler wishes and desires themselves. which their has been made express or a machine that simpler by machine by and in of under- the himself, position out Is not disease labora- therefore, of order? to-place being great put is with reference to their attitudes. This of Nature that tears standing vastly complex apart tory experiment even to worked at more than have certain into great for us and important length structures brings things promi- the he over association If he knows this been hidden in the mass nence otherwise would have experiments. that of the mind able to have a human not have is We would of undifferentiated comprehensive grasp mediocrity? fake and how works as a to care of the to what realize it whole, known about physiology comparable anything an in to Are not human its endeavor about if was not for disease. all our mechanism we know it bring do the and to mold !«> that of artificial the environment, path- adjustment experiments production laboratory He will be in a to its desires. then about environment suit would we have known conditions? What ologic he chooses to on the to the if so further it not been for go of bad position path, the aphasias? language problem to make of and there cortical we that was a special investigations special Could ever have phenomena presumed science. in the methods of refined or detail disease of function without apply laboratory localization naturally In short not the the at it is The of medical space my disposal possible, produced? psychology artificially of I nor have to outline the kind instruction that idea the human 1 tried, a of school should give comprehensive think be best to ends. I desire to confine itself would these in it is not only the and necessary adapted mind large as a mind to the for the of in order to do normal nor, emphasize necessity study to so-called that, psychology Downloaded From: http://jama.jamanetwork.com/ by a University of Manitoba User on 06/13/2015 earliest of the disease metastatie the medicine: T aim at and, for of stage therefore, practice only preparation is at a of this The details can arthritis rarely observed this stage. necessity. creating recognition few At first would seem in the in be at con- it cases are a that, any time; they secondary glance approached in all metastasis in tbe has taken the first arc after sideration to the and only which place joint general principle the a it must not that the week of details. And he forgotten finally, urethritis, personal idiosyncrasy gonorrhea! and of this cases are a deal of the has existed in of theory quoted vogue support great pseudoniodicine, "patent" have between the hosts of in which certain individuals remained well the half-baked charlatans patines, remedies, had whenever a and in nient of medi- but new attacks mountebanks are a attacks, thriving depart gonorrhea! new infection was I have cine that the has and urethral acquired. simply supposedly legitimate practitioner observed such but I am not able to and are to no small cases, plainly neglected, thriving repeatedly they The results that of since close extent because of that the good investiga- neglect. accept theory idiosyncrasy, — that in bad no one that do obtain tion tbe obtain and can they they conclusively patient question deny proved of of results obtained effect of the same case from the first attacks sometimes are the guild by gonorrhea the last it a more or Ibe minds of and all this urethritis to one. True, they luid in their on their patients, practices an or subactite is refuses to less acute on while the latent condition, going interrupted by general practitioner busy after such as which latter when a sexual himself with matters and the up. psychotherapy flaring appearing medical to teach structure and func- as evidence of a new infection. schools the intercourse was considered neglect the Here is field in which medicine has few in in which tions of mind. a The very cases recorded the literature of measured a neither availed itself its nor within few after a gmiococcus pycinia days opportunities appeared its and it does both infection be to an to of these fust could classified as due responsibilities, until up idiosyn- it can ill afford to throw but is it not that lesions like those stones. crasy, possible for the have the mentioned above opened gate might reference I have to lesions invasion? systemic particular Otherwise we could caused under by irrigation pressure. RELATION OF CHRONIC GONORRHEA THE such a understand there is small percentage hardly why INFECTIONS IN THE AND OTHER the of infec- of number considering large it, gonorrbeal URINARY TRACT TO JOINT and so few eases in the tion, particularly very occurring DISEASE of tbe disease. early stage the idea is that the More gaining ground recently F. M.D. KREISSL, source of of the in male adult, is infection the joints CHICAGO to be in retention foci of found the urogenital chiefly is local in a small As a rule a disease, but into gonorrhea from the anterior urethra the venal tract up pelvis. of the cases or its toxins of escape Such foci are established in the follictilar percentage germ through apparatus circulation and the and a the in the tissue of the anterior urethra, the lymphatics, systemic glandular Metastatic condition ensues. inflammation in the and in seminal vesicles. gonorrheal Cowpcr the gland prostate, in other structures, the the of an of the attacks, among many joints While examination gradually necessity 2 cent, of all cases of or 3 infection. an per in urethritis and its com- perhaps systemic unduly prolonged prostate The condition is to invasion sometimes due the of the few have became very yet appre- plications recognized, so-called joints the alone, sometimes to a the vesicles ciated the of seminal as a con- by gonococcus importance infection with bacteria or their mixed and the products. factor, even pyogenic only occasionally specialist tributing is more in men than in Gonorrheal arthritis common of in thinks the these cases. palpating Cowpcr glands the to almost immune to this women, latter be the of in the seminal And retention material seeming just septic is be to the which to due fact is for of vesicles a complication, supposed very responsible large proportion that and urethra is the usual of the not the seat chronic of vagina urethra] ever-recurring discharges, relapse in the a gonorrhea female. This, is however, and and metastasis in the only sup- epididymitis cystitis joints position. the at least as often We find initial infection and oilier lissucs. in the female urethra as in the is ln some of these cases there a but vagina. scant persistent believe the cause to be of this is increases on immunity urethral which of apparent discharge provocation found the structures in the differer.ee of of the female kind and or treat- some decreases with without rapidly tract to chance of and. the lesser others ceases under ment. In the urogenital secondly, entirely discharge the and course traumatic to urethra in the huai few vagina but within a after injury treatment, reappears days of Tn the treatment of a of our light treatment is discontinued. gonorrhea. present of of metastasis, it the gonorrhea! in there is no visible etiology others but the knowledge discharge, Again, either local a retention with trauma al contains shreds of requires urine times different size and subsequent of of the sort or an abrasion other are no on some protecting at times there shreds shape; epithelium present; "i allow the of the bacteria or order to their close a few minute floeculi seen escape are very inspection the the in toxins, into blood-vessels or Such a the otherwise clear urine. The shreds floating very lymphatics. be a but a sexual to the bottom of the indicates trauma mechanical one. excite- which may Shortly drop glass, from the Ihe conclusion of ment or a source serve and (he of congestion any may pus permits presence be shreds Same lesions The germs. purpose. Epithelial may produced by comma-shaped originate-in pyogenic the ducts of the the follicles and seminal from which 'mtritmenlation. but the invasion urethra deep prostatic oi' arc the terminal contractions the neck and the the of the vesical expelled by trigone by gonorrhea] they circular process to more or and muscle-fibers. less leading congestion bleeding ls In smaller an some cases more or less severe or sufficient to blood-vessels and offer a cystitis epididy- expose of of the bacteria and their toxins. Neither endo- mitis short duration, but is escape repeatedly recurring, "lethral invasion of the observed. instrumentation nor the pos- and the occurs If an articular should in the absence terior urethra in the occur trigone swelling usually of a months or visible urethral discharge, perhaps years of the of Branch the Amer- Read at meeting the North Central was after a urethritis cured and had ican 1912. Feb. long Urological Association, St. Louis, 6, apparently Downloaded From: http://jama.jamanetwork.com/ by a University of Manitoba User on 06/13/2015 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of the American Medical Association Unpaywall

THE STUDY OF MIND IN MEDICAL EDUCATION

Journal of the American Medical AssociationMay 11, 1912

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0002-9955
DOI
10.1001/jama.1912.04260050093003
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Abstract

of chemical for their in facts illustrate the difference in the the conditions the growth only virility propitious in situ. natural of the normal between isms disturbance equilibrium organ tissue and themselves. the to from the the causes spirochctes disappear Mercury arc the Some blood, and is therefore against changes necessary safeguard non-syphilitic greatest preliminary the of lesions of The infection. Whether the in ill all late maternal it attacks formation organism syphilis. or doubt the the the marrow where are no harbored seborrheic syphilids, lymph, they palmar Byphilids syphilid, is doubt of be taken as illustrations of this in latent ful. the mouth, syphilis, may To the is observation. me the that latent mother syphilitic theory of which in such is a how else could one cases blood-borne a spiroebete-carrier organisms Syphilis disease; arc the There are now and in (be and secondary lesions? many theories then, blood-stream, likely explain appear, of late dis- to settle at of or dis- lesions—l,evaditi*s physiologic explanatory points pathologic syphilitic all of if not of turbance local Neisser's the phenomena turbance, immunity, Umstimmung, explains many, etc. and also tertiary parental syphilis syphilis. Together anaphylaxis, with the of the lint how reach the areas of this must fact that the do the tertiary go recognition spirochetes a host for must carried the blood, and is an which can inhabit disturbance? be spirochete organism They by is mechanical or influences at a without It in chemical causing disturbance. slop years, interesting through results certain thus cause a lesion of this connection to note the of the observations of anil proliferate, point, in to So it is of and in relation or less with the cancer, more extent. Tyzzer pathogenesis Qaylord spirochetes when that in mice rats a new The woman in all and is, harboring spiroehotes, congenital syphilis. probability, at occurs in filled with the she has in her circulation, it is them, latently general growth frequently syphilitic; free are only tintes, live, which occasionally spirochetes organisms. has culture to her She have Now that a may syphilitic Noguchi proper pathogenic organism. developed in her or a oolonv in hod for the it will he much Scars vessels, met spirochete, probably possibly struggling llu ids arc the circu- easier to demonstrate it in and tissues. bcr aorta. The free carried spirochetes by suspected vessels The of the has been the into the or the testicle rabbit heretofore lation growing placenta, forming best such as of which numerous or abnormal and medium for demonstration, being present possibly cheapest are for. to and At rale. animals too areas them lodge propagate. any higher expensive. but to find in the is tissue with less resistance The are difficult there pla- spirochetes very growing possibly the sides of centa hut cultural methods more seek writers failures, vnsciilarily. mechanically ; many They report the is most fre- be of assistance in a colony formed, and this is will clearing up many vessels; patho- great is that found on the side. conditions. It highly possible embryonic placenta! quentiy logic with Loeb, he the attributed to In this over Dr. Leo in placenta, talking many appearances syphilis, theory Two he carriers to me : factors are not this disease. women the may Pregnant suggested following explanation of be as for the this other besides the greater in spirochete. suggested responsible way organisms may possibly whom of to show lesions. In' are in the the There organism syphilitic spirochcte-earriers liability placenta the the a there arc first mixed is as nieningocoecus being organ, innocuous, typhoid place placenta, partly just is Clinical observations and of of and carriers. origin, only many maternal, probably diphtheria partly embryonal at the of those other lines to a extent influence substances seem, less under along experimental investigations the at least to in infected which cause least, confirm this fact. mother, originating partially a of the maternal lesions. it partial Secondly, 412 immunity Humboldt Building. of is tissues in active thai certain pro- process possible such extent in to liferation differ their cell-metabolism an certain as do not to stimuli thai effectively they respond MIND MEDICAL THE STUDY OF IN do tissues. as functionating quiescent normally EDUCATION ll is ran- lind In the to decidua, extremely spirochetes side. bul are found on the embryonic WILLIAM A. M.D. they frequently WHITE, The various conditions of the placenta depend pathologic D. C. WASHINGTON, in «ni The the location of the colonies. organisms find It a most is that it is the obvious for truism as the best media growth frequently the elsewhere, placenta, nearest at that is overlooked the hand, about vessels. thing, thing the has in and not For the been from a fresh seen. an strain generations physician If syphilis early vigorous arisen and here and there has one of the fetus his is an death will the practicing art, only early parent planted, has considerable to fact becomes who the strain more attenuated any thought as the given plain occur; generally is And while in that man a of the bodies of the under influences immunizing thinking, feeling organism. the learns a the older children or latent good way physician undoubtedly syphilitic practical parent (an syphilis), of to deal with his as he or infection children the empirically patients thinking organ- horn; syphilitic may all be still in of medical education there is that it the fetus from so mild a strain isms, process the be may may of to inculcate this fact into the mind little effort made out the hereditary by immunizing entirely stamped the to to him student, much less endeavor teach about child. influences of the the of the and mind, its the rule of that older functions, It is a standing the organization way clinical long in which it as is reacts to disease he is these the the less likelihood there in the taught things parent, syphilis (hat in the which is fact about fur infection of child, due to the every organ body. Ihe The reason for this lack of of the mental and she Such host less that those appreciation a contains spirochetes. arrive in not to at. We nient how- life is My docs virulent. must easy harbor are less ion, conception altogether the reason is that tremendous that the of the shown inocula- of that Noissor has complexity ever, experimental bus reason course in a human which hallled man's for so run same tions lesions the organism, from tertiary is to to be while others have understand, as from an lesion; many generations only beginning earlier chimpanzee Bhown inoculations from that secondary retrograding Manhattan of Read at a of the Medical New meeting Society These two York lesions variable and uncertain results. March 22, 1012 City, give Downloaded From: http://jama.jamanetwork.com/ by a University of Manitoba User on 06/13/2015 so a fathomed that of unstable his mentality must so that after sufficiently grasp be, although comprehensive all, the has entire loomed on the horizon as an illustration have to be original been up my might problem supposed it when is imminent nnd is svch a com- it not such from sore a far the to possibility only cry finger academic, the is that the of mind clinical of the disordered grasp possible actual, prehensive phenomena practical, problem into at for deal mind. for consideration ia.ll place all, they with the as a it It will seen above whole and therefore be from the organism how primarily simple example after how is its in their interrelations and close, intimate, are the relations between only parts separate existing been the the the have understood that so-called mental and so-called how and problem interdependencias physical, one is of the whole can he when the affected other become approached. easily may involved. I take It is not at this time to enter into that it, all are to admit. This, my object willing of between I.el where much-worn discussion the relations us Bee ¡1 leads a subsisting US, short time a Only ago and mind. I will call attention the fact man came into who to a that I am merely my office, represents body type in have afraid is too com mon. that the the interests of the been He of past physician only complained depres- on the he has at an to centered and that looked the sion, inability work, drowsiness and lack of body from and such individual the of ail- lie ambition, indefinite bad rested purely standpoint physical symptoms, ment. and be exercised be bad bad been to the mountains ; and us a to Let for take the other the seashore; he bad tried in the him- moment, however, solve point problem at and he had had of view and let us look the situation from the self, the advice of he had physicians; been the hands mental rather than from the does of the angle. Why genilo physical through -urinary specialist the inconvenience with no he was who is from and results; convinced thai he was patient suffering pain suffering a. sore for the from some Kind of and he been of consult It niilo-iiitoxication. had finger, instance, physician? will be that is I the hands of said it is because his sore. a who say no, finger through gastro-intestinal specialist, is reason. It is sent him This had been that not the because he is ill at to me. man able to after (ind. mentally not a one. an exhaustive ease. The reason is a mental one and the of slightest kind an physical only examination, in the it will be the man has in his and starches said, linger of in the But, pain apparent deficiency digestion The a and that is the reason he consults that is intestines. looked to be in the patient physical thing physically of I that is not so. The condition, lie had been to his doctors and Again say no, many physician. pain pink does not in the is not a bul rune of them had been to find the reside able mutter finger; physical pain anything a to the with and be mental fact, While the is due him all seemed to obsessed whatever, pain directly they itself is of condition of the the with the some kind of elaborating physical finger, pain purely necessity hypoth- man mind he could esis to a mental If the had no his without of them ever experience. explain Bymptoms any And I reason that have no that the he consults were mental. An hour's talk with again say supposing they pain. the he ill at ease. What this man enabled me to make a clear is that is mentally physician perfectly diagnosis. lie does the for The usual answer will was those mild do him? a of one of manic- typical physician example be that ailment. This is true; Im I that we the he cures the know name of physical depressive psychoses by in so a means to the end of true he had he is It is that certain doing only cyclothymia. physical employing mind at rest. He was the After the individual's Bomewhat symptoms. troubled with putting patient's constipa- then he no suffers tion for and I mind is satisfied lie is as recall was the that about well; longer it, example, there suffers from the that of he he no that did ; knowledge only physical any consequence pain longer symptom is on his and he is have. He had found mil a at. that body, brisk disagreeable-looking place by taking good cause be felt and it is the of his Cathartics better, on BUCll a true, peace because, physical occasionally has a of been been removed. basis auto-into.xiciition had theory flimsy suffering elected his Some that this result is in mind. And so we have hen- a case is that by dealing say accomplished mental in its the I certain a case, all for with admit that doing things mistaken by absolutely features, finger. and this but I insist thai a condition treated as such in of the to the one result, spile finger produces physical results so far as to find any real the ultimate the comfort and to take produced, inability tangible physical thing of are hold of! the are mental well-being patient concerned, the that the Then we a of cases that of results and that are in have class nil sorts changes develo)) wrought of are to of about such a disturbances after slight errors the end bringing gastro-intestinal very finger only effmts I admit that I have taken an diet, or after or with- mental condition. will as moderate involving fatigue, ¡Ilús- an extreme in older 1 out cause we bave a certain instance that might any apparent upset physical example the the hut us is focalized in the trale of view from menial let that svstem, and point angle; gaslro-intestinal little and with the are treated in or diet- a further examine, the aid of these one bv way proceed patients another, matters a lo and ! the end of or crucial lest; of all medical, case that came rest, and behold two ing, by by observation three we have bands a limlei' some time since. years we find on our developing my of a sore and it is that case of dementia nnd we learn cases that It was the case for such prsecox, by finger, such 1 it here. A man had nol the out- reason that introduce precede frank young Bymptoms infrequently his it break of the and so we (ind of what wounded one of and was back fingers, infected. again psychosis, slightly surface are There of the on the a mental condition was a inclosed in single pus physical drop symptoms perhaps serious of far more and overlooked. and there was a rise infected usually slight tempera* territory, Then we have a host invalids 99 hut man was whole of neurasthenic as I recall about the F.; young ture, it, who have with of in some trouble them: a tbe and delirious. What now becomes of the sore ovary. bed, cyst of a a in this situation? The tbe uterus, chronic floating and .its appendicitis, finger problem prolapse general of other and as info as an and all sorts as the a is sunk days Conditions, finger insignificance, kidney, finger except and months to much the themselves mit index to the the much more into larger, go by drag years point way The these a toward of the individual. infection is reaction their patients develop physical important, problem which is of 01 measures the out all to the luit a barometer thai the resistance of malady degree proportion are a tremendous and one of a the itself. with mentality, drop pus, temper- malady They building patient's of structure of disordered mind on small foundation of 99 F. and one can see how a ature seriously delirium, Downloaded From: http://jama.jamanetwork.com/ by a University of Manitoba User on 06/13/2015 and do have that the actual cost of the although something remembering maintenance of physical ailment, they the with them is matter still the the individual the smallest physically physical thing single of probably portion to feature in cost to has since ceased be the the his real the he be if a long important community, especially if work and the to a miracle and the head of a case, attempts wage-earner physician family. and cure over out an these old The next class to that has be considered in people night, by taking great this or a a connection consists — or neph- of the idiots and imbeciles appendix indi- performing ventro-BUspension he will have of his serious dis- viduals whose one is ropcxy, professional again inefficiency the 'result of plainly not retire mental and and will he disease defect, Then a only conies considerable appointments ultimately front the tie-field beulen and bal but he will class of of are whom defi- chagrined, deaf-mutes, many mentally also most the fail What is the cient: while we are more, know so. hopelessly. patient epileptics generally better instead of will be for the Aside from these classes arc worse, that conceded b> being throughout generally builded certain have on this a to the field mental of there are they physical thing belong medicine the years of and the attitude of the who structure are not to hope physician may paupers, in generally supposed belong them believe this after have made that when it was removed but what, is class; but an they all, pauperism would be when of this to come to to in the all fails after pass inability get world, and whai, is well; along all, are an to into the intricacies of their in the mental world but a they plunged deeper inability get along Ihe menial And here we see the of with of of the tangle. again inability, course, importance exception, relatively mental element. And on cases of the so I few disablement? might go interminably physical illustration after illustration. Then, one who with any has bad considerable again, any I have said about which. I the criminal with classes knows nothing hysteria, may that experience prac- in is a the mention I have entire of pure only the criminal is a mental psychosis* tically problem passing, intimated field the the existence of the tremendous of while such social as problem, questions prostitution and I have that not mentioned again themselves under the same very group general category. psychoneuroses, of the the so-called I could on of all of these huge group psychoses, give state- symptomatic example example and mental conditions that disease in ments, but the limited of such a as bodily this accompany space paper of is infections. Not all those il are various The recent work only with (lie groups quite impossible. juvenile menial eases from the of medicine however, has delinquent, all of these important standpoint emphasized points in the but it is that attention and Over over large, again. extremely important to as fall mid- this work be addressed them, because it has also were, shown that they, Fortunately many between the fields of of the internist and defective mentally children are so only way operation apparently do the not come within the because of removable defects. Here is a psychiatrist. They purview physical boy, of in their earlier the least manifesta- for ai who is mentally all psychiatrist, example, defective; apparently heed while the internist little to them because he needs is an adenoid Here is another who tions, pays operation. he is not so a of a studv and field medicine, is and it would interested, irritable, seem tremendously really of not to is if which could fail be as he be a neglected murderer when he The enlightening, might grows up. because of this situation. whole is a is which correctihlc. purely practical difficulty myopia readily In various cases of mental to On the other a reviewing the groups here is defective four or hand, girl, which 1 but directed have I think one attention, five behind There is a casually years who psychologically. girl it cannot fail to see that no small number. will a become or a or Now comprises both. is prostitute criminal, While I not to subscribe to the statement to am the time tackle the of prepared whether she will or not.' problem of one of at a medical that friends recent meeting The of my and of have problems criminality prostitution disease of is most been social one these neuroses alone the common as far back as the of man problems history in all I if be still think' that the matter and has been the made to medicine, given goes, solve attempt always it be conceded at careful will that it is least them the by with but one can thought finished dealing product, c\dc< as to or nol this of diseases im more debatable whether make an on wait- these group impression problems by real not as or more, in finit until time than one can the of much, center produce perhaps suffering ing change the than the and of diseases the has been do for earth. Man to it community physical injuries. gravity trying into 1 bold to So. without more detail make thousands of and he is where he started. entering years, just believe that is clear. What is use of the until this for my point waiting girl, example, all truths before us T With these return to the a original shall have become and shall have infected prostitute, that the of medical education statement innumerable brilliant and during period young men, perhaps promis- im or at least no attention, is wiih lo their is attention, systematic ruin. It too ing, syphilis, everlasting to the mind same addressed in like the laic when has is when degree that occurred. 'Pbe time she anything now. of that to of is devoted the consideration is a so 1 and on afb-r thoroughness child, for might go indefinitely, one of the even the brain itself, and the •any organs, ramifications and the bodily nil, tremendous for importance if that I have ask. these been things mentioning repre- the of the state of as these such well-being problems I believe sent an of and a cases, make lot of the of group they activities medicine important sanitary general not now consideration do. is the time for such look a deal like a in beside them seriousness. why ripe good joke in the médical One be what curriculum? now. T may wondering advocate perhaps, us a at of in the of Let further, and some the of mental step glance way study conditions in the go just the are to social and that usually considered he medical T a course of advocate svs- problems college—-whether see the what mental medicine has on them. To tematic and and the like. T shall bearing laboratory psychology not call attention. what great of the insane I need not discuss and what not to be group ought ought taught It thai the in is evident within domain the of we they belong whether shall quite way psychology investigate of I if we ever the of and make mental medicine. the wonder, however, stop student problems go perception to think the ¡mínense of of of économie their a scries with the importance through laboratory experiences There are over insane taken or we problem. 180,(1(10 whether shall him a lot being of tachistoscopc, give at pare of in the institutions of this association to his country puzzle brains. Those are public experiments in present. Think that means dollars and matters of detail. The what main is to cents, thing acknowledge Downloaded From: http://jama.jamanetwork.com/ by a University of Manitoba User on 06/13/2015 to the at of the other confine itself to abnormal of least as much the on psy- knowledge hand, necessity do of as on in order to it. It take its illustrations structure and the mind is insisted may workings chology the and T of It reference to one of think from field mental however, with any activity. should, any organ body, is of in its trends and be the same kind of the most fundamental he humanistic knowledge prominently primarily reaction times. a of motives rather of I have the student who leaves bis than would psychology importance. no of I not a reaction times has to on medicine do that of medical enter the say practice psychology college It, a of the that all but it is refinement realize his are of them has, psychology thinking, feeling patients place. to medical and not a and the which is of the student that human mind itself much advantage beings, comports for such of a a like the of the much like any organs psychology. body, living precondition wliieb I like to call I have know bow is The last few of would him it built years psychiatry, organism. up, have suffi- the about the somewhat of its structure and its Renaissance necessity brought mechanisms, period, kind of I of for the advocate a so its as he that he psychology ciently may psychology appreciate phenomena and human and would human motives, much of it will them manifested in the and I beings very sec sick-room, he called a him of Ibe iniiinr- might common-sense have understand the more readily psychology operation the which not lite or erudition of the result of does learning tant and that are mechanisms require processes to understand its prin- disease. laboratory investigator general If Ihe human is looked on as a neces- mind reacting I think I have said to demonstrate the ciples. enough of defense and reactions of some Conn of in connection compen- developing sity organism psychologic teaching as the and sation with medical I some develops compensations éducation; add precisely body might systematic defenses of the obscure inaiii- In otherwise dust he 1 am not many form, what the details should disease, going of the mind can la- The fcslalitiiis disordered to to I wniii to draw certain explained. attention suggest. merely curve with disease a A deal that is hip develops compensatory broad now patient general great principles. of (he that, his center of is not so disturbed. than as is more nor less spine gravity taught psychology really nothing lo The with antibodies the antag- and he in connection with diphtheria develops could patient physiology taught onize the and so tbe with menial course in for as the toxins, patient Such invading example, physiology. things, to a are disease us series of reactions that color fields presents of the sense organs, perception, physiology in There character. are two defensive and of taste and of and smell, differentiation compensatory vision, hearing for in Government the — the to Hospital etc. all these be added the patients to-day sensations, might haptic Both them have Insane who have committed of murder. in course physiology. is the killed not, the delusion that is person they I want Io the old- The main that combat developed thing in II, does not fact dead. recondite any and delusion require psy- fashioned, time-honored widely accepted to bow the of such a understand a of the chology development that it is to have full necessary understanding to in of delusion enables them live peace before the comparative so-called normal human mind the of study them from mind. The delusion defends the reality; mind is entered This is human on. delusion diseased oilers for the their them a psychosis compensation on two fallacies. The first is the based fallacy gross and arrows forl tine." of "slings outrageous is as normal mind, that there such a human any thing look the is to on beginning to-day psychosis lias been Psychiatry or at least that such differentiated any thing of as a but as an the of not disease, type expression so we know what it is. The that psychologists may reaction to inimical conditions. The of the individual mind have never told us what the normal certainly not the delusion is the outward delusion is the disease; it can to and what he consisted of. advantage possible the the that is of process expression repair process select combinations of mental out of the kaleidoscopic to about anil balance in the bring harmony elements and label endeavoring one certain arrangement particular so he at mental that live may peace make-up of other patient's it normal and maintain that, none the arrange- at with The not himself. least, psychosis, infrequently, that one is be until ments thoroughly may investigated from is the resort of the individual a world of in reality understood is Secondly, why beyond my comprehension. builds which cannot, live. by means he The up. patient that in to thesis order under- should the be maintained wliieb it; an artificial world to of his delusional system, select for we should the certain mechanisms stand study is which can live. to himself—in be these are possible adapt which most machine in mechanisms complex which I have is the kind of This, is at briefly illustrated, machine at a time when that working represented, with which Ihe student should enter for college of and psychology its perfection, pur- highest efficiency degree his be able mi life-work. He should to see the operation is it not a more of As a matter of fact, poses study? in the of motives his to mechanisms understand of lake either a attitude mind to patients, reasonable simpler wishes and desires themselves. which their has been made express or a machine that simpler by machine by and in of under- the himself, position out Is not disease labora- therefore, of order? to-place being great put is with reference to their attitudes. This of Nature that tears standing vastly complex apart tory experiment even to worked at more than have certain into great for us and important length structures brings things promi- the he over association If he knows this been hidden in the mass nence otherwise would have experiments. that of the mind able to have a human not have is We would of undifferentiated comprehensive grasp mediocrity? fake and how works as a to care of the to what realize it whole, known about physiology comparable anything an in to Are not human its endeavor about if was not for disease. all our mechanism we know it bring do the and to mold !«> that of artificial the environment, path- adjustment experiments production laboratory He will be in a to its desires. then about environment suit would we have known conditions? What ologic he chooses to on the to the if so further it not been for go of bad position path, the aphasias? language problem to make of and there cortical we that was a special investigations special Could ever have phenomena presumed science. in the methods of refined or detail disease of function without apply laboratory localization naturally In short not the the at it is The of medical space my disposal possible, produced? psychology artificially of I nor have to outline the kind instruction that idea the human 1 tried, a of school should give comprehensive think be best to ends. I desire to confine itself would these in it is not only the and necessary adapted mind large as a mind to the for the of in order to do normal nor, emphasize necessity study to so-called that, psychology Downloaded From: http://jama.jamanetwork.com/ by a University of Manitoba User on 06/13/2015 earliest of the disease metastatie the medicine: T aim at and, for of stage therefore, practice only preparation is at a of this The details can arthritis rarely observed this stage. necessity. creating recognition few At first would seem in the in be at con- it cases are a that, any time; they secondary glance approached in all metastasis in tbe has taken the first arc after sideration to the and only which place joint general principle the a it must not that the week of details. And he forgotten finally, urethritis, personal idiosyncrasy gonorrhea! and of this cases are a deal of the has existed in of theory quoted vogue support great pseudoniodicine, "patent" have between the hosts of in which certain individuals remained well the half-baked charlatans patines, remedies, had whenever a and in nient of medi- but new attacks mountebanks are a attacks, thriving depart gonorrhea! new infection was I have cine that the has and urethral acquired. simply supposedly legitimate practitioner observed such but I am not able to and are to no small cases, plainly neglected, thriving repeatedly they The results that of since close extent because of that the good investiga- neglect. accept theory idiosyncrasy, — that in bad no one that do obtain tion tbe obtain and can they they conclusively patient question deny proved of of results obtained effect of the same case from the first attacks sometimes are the guild by gonorrhea the last it a more or Ibe minds of and all this urethritis to one. True, they luid in their on their patients, practices an or subactite is refuses to less acute on while the latent condition, going interrupted by general practitioner busy after such as which latter when a sexual himself with matters and the up. psychotherapy flaring appearing medical to teach structure and func- as evidence of a new infection. schools the intercourse was considered neglect the Here is field in which medicine has few in in which tions of mind. a The very cases recorded the literature of measured a neither availed itself its nor within few after a gmiococcus pycinia days opportunities appeared its and it does both infection be to an to of these fust could classified as due responsibilities, until up idiosyn- it can ill afford to throw but is it not that lesions like those stones. crasy, possible for the have the mentioned above opened gate might reference I have to lesions invasion? systemic particular Otherwise we could caused under by irrigation pressure. RELATION OF CHRONIC GONORRHEA THE such a understand there is small percentage hardly why INFECTIONS IN THE AND OTHER the of infec- of number considering large it, gonorrbeal URINARY TRACT TO JOINT and so few eases in the tion, particularly very occurring DISEASE of tbe disease. early stage the idea is that the More gaining ground recently F. M.D. KREISSL, source of of the in male adult, is infection the joints CHICAGO to be in retention foci of found the urogenital chiefly is local in a small As a rule a disease, but into gonorrhea from the anterior urethra the venal tract up pelvis. of the cases or its toxins of escape Such foci are established in the follictilar percentage germ through apparatus circulation and the and a the in the tissue of the anterior urethra, the lymphatics, systemic glandular Metastatic condition ensues. inflammation in the and in seminal vesicles. gonorrheal Cowpcr the gland prostate, in other structures, the the of an of the attacks, among many joints While examination gradually necessity 2 cent, of all cases of or 3 infection. an per in urethritis and its com- perhaps systemic unduly prolonged prostate The condition is to invasion sometimes due the of the few have became very yet appre- plications recognized, so-called joints the alone, sometimes to a the vesicles ciated the of seminal as a con- by gonococcus importance infection with bacteria or their mixed and the products. factor, even pyogenic only occasionally specialist tributing is more in men than in Gonorrheal arthritis common of in thinks the these cases. palpating Cowpcr glands the to almost immune to this women, latter be the of in the seminal And retention material seeming just septic is be to the which to due fact is for of vesicles a complication, supposed very responsible large proportion that and urethra is the usual of the not the seat chronic of vagina urethra] ever-recurring discharges, relapse in the a gonorrhea female. This, is however, and and metastasis in the only sup- epididymitis cystitis joints position. the at least as often We find initial infection and oilier lissucs. in the female urethra as in the is ln some of these cases there a but vagina. scant persistent believe the cause to be of this is increases on immunity urethral which of apparent discharge provocation found the structures in the differer.ee of of the female kind and or treat- some decreases with without rapidly tract to chance of and. the lesser others ceases under ment. In the urogenital secondly, entirely discharge the and course traumatic to urethra in the huai few vagina but within a after injury treatment, reappears days of Tn the treatment of a of our light treatment is discontinued. gonorrhea. present of of metastasis, it the gonorrhea! in there is no visible etiology others but the knowledge discharge, Again, either local a retention with trauma al contains shreds of requires urine times different size and subsequent of of the sort or an abrasion other are no on some protecting at times there shreds shape; epithelium present; "i allow the of the bacteria or order to their close a few minute floeculi seen escape are very inspection the the in toxins, into blood-vessels or Such a the otherwise clear urine. The shreds floating very lymphatics. be a but a sexual to the bottom of the indicates trauma mechanical one. excite- which may Shortly drop glass, from the Ihe conclusion of ment or a source serve and (he of congestion any may pus permits presence be shreds Same lesions The germs. purpose. Epithelial may produced by comma-shaped originate-in pyogenic the ducts of the the follicles and seminal from which 'mtritmenlation. but the invasion urethra deep prostatic oi' arc the terminal contractions the neck and the the of the vesical expelled by trigone by gonorrhea] they circular process to more or and muscle-fibers. less leading congestion bleeding ls In smaller an some cases more or less severe or sufficient to blood-vessels and offer a cystitis epididy- expose of of the bacteria and their toxins. Neither endo- mitis short duration, but is escape repeatedly recurring, "lethral invasion of the observed. instrumentation nor the pos- and the occurs If an articular should in the absence terior urethra in the occur trigone swelling usually of a months or visible urethral discharge, perhaps years of the of Branch the Amer- Read at meeting the North Central was after a urethritis cured and had ican 1912. Feb. long Urological Association, St. Louis, 6, apparently Downloaded From: http://jama.jamanetwork.com/ by a University of Manitoba User on 06/13/2015

Journal

Journal of the American Medical AssociationUnpaywall

Published: May 11, 1912

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