bluuebunny/crossref_metadata_2025_split huggingface dataset:
Some Considerations of Vertigo Based on Experience
Authors: Müller Isidore 
Published: July 2019

Our only direct intimation of the existence of space is the sensation of vertigo, when through our cortical centres we become conscious of the fact that we are surrounded by a “blank” space in which motion is apparent, i.e., the relative condition of our body to the things around us seems to be altered. A precise account of the “nerve-cycle” and of its exact relation to the sympathic and parasympathic—in a word, to the autonomous vegetative—system and to the endocrine system, is at present impossible. We have known since the time of the classic investigations of Flourens, Breuer, Mach, Crum Brown, and their followers—especially Sherrington—that the nature of these things is highly complicated. Simple mechanical theories are useless, even for teaching purposes, as they are more or less fictitious and often incomplete. The path of nervous action is through the ear, cerebellum, brain stem, cerebrum, medulla oblongata, spinal cord, and autonomous nervous system, to the different parts of the periphery, and there are also mutual connexions with the endocrine glands. Mention is made of the influence of constitution (i.e., inheritance, “the natural endowment”), and also of the conditional disposition, temper, training, in a word all external and internal stimuli. Again, the various reflexes, the numerous aggregations of ganglia, indicating a certain autonomy of function, constitute a great problem for future clinical observation. The mechanism of adaptation and compensation by which extensive injury may sometimes be counterbalanced, also enters into the question, as do the varying collateral paths, the synergetic action of different and sometimes very distant organs and so forth. Again, we have to think of the ratio of irritability and fatiguability, a significant factor in causation. Syphilis, arthritis, alcoholism, nicotine-poisoning, anæmia, leukæmia, tumours, and—especially—catarrh, are most important causes.
Treatment of Pelvic Inflammations by Diathermy
Authors: Robinson C. A. 
Published: July 2019

The paper consists of two parts: (1) A brief history of the manner in which the treatment arose and a description of the methods now used. (2) An analysis of the cases treated from 1921 until the present time. The treatment of pelvic inflammations by heating by the diathermy current arose out of the method of treating gonococcal infections of the cervix and urethra by this current. An essential part of the treatment is in many cases the treatment of the cervical infection. Diathermy treatment of gonococcal infection was founded upon the fact that the gonococcus is vulnerable to small rises of temperature above the normal. Before the war Dr. E. P. Cumberbatch found that recovery of gonorrhœal arthritis could be procured by heating the affected joints by diathermy. During 1919 the method of heating the cervix and urethra by means of metal electrodes introduced into them to rid them of gonococcus was arrived at. The maximum temperature to which cervix and urethra are heated is 115° F. The duration of the application is ten minutes and the number of repetitions is generally from three to eight. It was found that in cases of gonococcal arthritis it was necessary to treat the cervix only, recovery from the arthritis then taking place. Recovery from arthritis due to infection of the cervix by other organisms than gonococcus, was found to occur and in such cases there was recovery from cervicitis and erosion. When salpingitis was present in cases of gonococcal and other infections of the cervix, a method of producing a milder and more general heating of the pelvic contents was introduced. This was to some extent founded upon the known effects of heating the infected prostate. The temperature produced in the neighbourhood of the electrode is 106° F. The applications last twenty minutes. Tables summarizing the clinical results are attached.
An Attempt to Classify (Pathologically) the Various Fundus Pictures in Diseases of the Choroid
Authors: Hepburn Malcolm L. 
Published: July 2019

Mr. Hepburn read a paper on the above subject, and by means of suitable fundus drawings endeavoured to prove that all pictures could be relegated to one or other of the following groups:— Inflammatory: ( a) Acute stage; ( b) scarred stage. Vascular: ( a) Acute stage; ( b) scarred stage; ( c) slow progressive changes due to disease or spasmodic contraction of the vessel walls. Hyaline, calcareous, and similar degenerations of the membrane of Bruch. New growths. Congenital; including colobomata. Injuries; leading to concussion changes and ruptures.
Corneal Transplantation on an Opaque Cornea
Authors: Thomas J. W. Tudor 
Published: July 2019

A man, aged 22, had opacity of both corneæ, following severe interstitial keratitis at the age of 18. Vision reduced to that of hand movements. Corneal transplantation performed on left eye in November 1930. The graft was taken from an eye removed one month after a perforating injury. Operation performed under cocaine anæsthesia, using the technique established experimentally in rabbits, with the addition of a glass disc interposed between the graft and the overlying stitches. The graft was slightly smaller than the piece of opaque cornea removed, and the margins of each were cut shelving.—The stitches and glass disc were removed on the tenth day; the graft had united well and was nearly clear.—During the next week it began to get hazy, and some minute blood-vessels appeared in its stroma, so that vision deteriorated; a few weeks later it began to improve. Four months after operation patient could count fingers at 2 ft. Two years after operation he could count fingers up to 33 in. with the light behind him.
Some Aspects of the Psychopathology of Sex Perversions
Authors: Hadfield J. A. 
Published: July 2019

Importance of the study of perversions. Precipitating causes. The attempt to explain them by the association of ideas or by simple conditioned reflex is inadequate. Perversions are found to be the persistence of morbid reactions of infantile life. The sex perversions have the same general causation, and the same mechanism as the other psychoneuroses. The essential factor in causation is the feeling of deprivation of love: This interpreted biologically as well as psychologically. Infantile sensuousness is to be regarded as biologically egoistic and not sexual. Its transference to the uses of sexuality later. The perversions are not the mere persistence of these normal infantile tendencies but are morbid reactions to abnormal situations. These morbid reactions are further repressed, which accounts for the fixation and arrest of sexual development. The precipitating conditions arouse the latent repressed tendencies, which therefore emerge in the form in which they were originally repressed.
The Composition of Human Perspiration (Samuel Hyde Memorial Lecture)
Authors: McSwiney B. A. 
Published: July 2019

Water given off by the skin is classified as insensible and sensible perspiration. Under normal conditions about 600 to 700 c.c. is evaporated from the skin in twentyfour hours. The chief physiological significance of the perspiration is to assist in regulating the body temperature.The constituents of perspiration are very variable. The average values calculated from the examination of fourteen male specimens and ten female specimens are given below:—[Formula: see text]Examination of the figures obtained for the sweat shed by rheumatic subjects shows no marked divergence from those recorded for normal subjects.Lactic acid is stated to be present in relatively large amounts in sweat, but these results have not been confirmed.Moss (1923) demonstrated the importance of the loss of chloride which occurred during continued sweating. He showed that symptoms of water-poisoning occurred when men engaged in hard work in hot places drank water freely.Hancock, Whitehouse and Haldane (1930) point out that the percentage of chloride in sweat increases markedly with duration of sweating, and suggest that water poisoning is due to an alteration in the diffusion pressure of water in the body.The secretion is under control of the nervous system, and is normally excited through stimulation of the centres by warm blood. The sweat-glands are innervated by fibres of the sympathetic system. Adrenaline has, however, no action on the glands, while pilocarpine excites and atropine paralyses. Recent investigations suggest that acetyl-choline is liberated at the nerve-endings.
Malaria from a Zoological Point of View
Authors: Christophers Rickard 
Published: July 2019

Protozoal parasites occurring in the red cells of mammals are: Hepatozoon, Babesia, Theileria and Plasmodium. The frequency with which these forms occur differs considerably in the different mammalian orders. But whilst there is a relationship apparent between the mammalian stem and the form of parasite, there appears to be an even closer association with the type of blood-sucking arthropods which the mode of life of the animals in a particular stem favours. Ungulates in the days of their greatest development chiefly roamed in herds over rather arid country not favouring mosquitoes, but suitable for tick infestation. Monkeys and bats are more likely to live in a humid sheltered environment where they are more liable to attack by mosquitoes. Knowledge of the plasmodial parasites of monkeys has up to recently been very meagre, but from the work of Sinton and Mulligan it appears certain that in the main distinct parasites occur respectively in the Oriental and Ethiopian regions, just as the genera of monkeys under present nomenclature are mainly confined to one or other of these zoo-geographical realms. P. brasilianum occurring in the Neotropical monkeys is a distinct parasite from any Old World form. None of the monkey parasites are probably really very close to those of man. The apes evolved as part of a great Pliocene fauna, and their remains occur in Europe, Egypt and India. The progenitors even of the present-day African forms are found in the Indian deposits. In the gorilla and chimpanzee, forms of plasmodium, so far described, appear to be very similar to those of man, including the characteristic cresceni forms. In the main the races of men are essentially Pleistocene and Palæarctic. They none of them form true Neotropical, Australasian or Oriental man in the zoological sense, but it is less certain there is not a relationship in the case of the Ethiopian region. The parasites of malaria in any case do not show any apparent relationship to the usual zoogeographical realms, and their distribution and prevalence appear to be determined on quite other grounds than those normal to zoological distributions. P. vivax occurs almost throughout the world within the July and January isotherms of 60°. P. falciparum is limited by the isotherms of 70°. Quartan is believed by Knowles and Senior White to have a peculiar geographical distribution. Frequency of occurrence is, however, entirely different from distribution, and this parasite probably also has its distribution determined by factors other than those usually concerned in the distribution of animal forms of life. Among other features it appears to be associated with areas of severe endemicity, and becomes conspicuous when transmission is abeyance. Mer has recently shown that it has a very slow development in the mosquito, and this may explain some of its peculiarities.
The Otosclerosis Problem: Including Reports of Two Cases Pathologically Examined (Dalby Memorial Lecture)
Authors: Gray Albert A. 
Published: July 2019

The essential causative factor of otosclerosis is a gradually increasing defect in the vasomotor mechanism which governs the nutrition of the structures of the organ of hearing as a whole. The axon reflexes are, of course, included in this vasomotor mechanism, and the stimulus which excites the vasomotor mechanism is sound and sound alone. Consequently the vestibular apparatus and the semicircular canals are unaffected in otosclerosis. There is no evidence whatever of any defect in any of the endocrine glands or their secretions in otosclerosis. Neither is there any evidence of any defect in the bone metabolism of the body. On the contrary the subjects of otosclerosis are, apart from their deafness, perfectly normal individuals with ordinary average health. The deafness of otosclerosis bears very little relationship to the extent of the disease in the bone. The deafness may be very severe when the stapes is hardly fixed at all. The severity of the tinnitus bears no relationship at all to the extent of the disease in the bone. The extent of the change in the bone bears very little relationship to the duration of the disease. The extent of the changes in the bone appears to depend upon the age of onset of the disease. The earlier in life that the otosclerosis begins, the more extensive will the bone lesion become. The deafness of otosclerosis is to a large extent functional, and is the result of the insufficient supply of blood to all the nerve-structures concerned in the perception of sound. The preponderance of women as subjects of otosclerosis is the result of the greater instability of their vasomotor system and the more frequent disturbances to which it is exposed. The changes in the bone show a remarkable bilateral symmetry even to minute details. This symmetrical distribution is readily explained by the writer's view of the causative factor of otosclerosis. The vasomotor nerves governing the nutrition of the organ of hearing are anatomically symmetrical like other nerve-structures in the body. If, therefore, structural changes occur as a result of defective functioning of those nerves, such structural changes will naturally be bilaterally symmetrical in their distribution.
The Treatment of Otosclerotic and Similar Types of Deafness by the Local Application of Thyroxine
Authors: Gray Albert A. 
Published: July 2019

The treatment described is the rational sequence, dependent on the writer's vasomotor explanation of otosclerosis. It consists in the local application of thyroxine to the ear. Many years ago it was observed by the writer that thyroid extract applied locally to the mucous membrane of the nose produced an active congestion without inflammatory reaction and lasting for a long time. If otosclerosis is the result of a defective vasomotor response in the small blood-vessels of the ear, then thyroxine locally applied might overcome this defect. Fourteen cases were treated and very considerable improvement resulted in seven of these (50%). Of these seven, tinnitus was greatly relieved in those in which that symptom was present. Wax also began to be secreted again. The subjective symptom of paracusis, usually considered of very unfavourable significance, is no contra-indication to this method of treatment, as two of the most successful cases were the subjects of paracusis. The method of application is very simple and is described in full in the paper. Cases which are not suitable for this treatment are very advanced cases, and those in which there is any serious loss of bone conduction, or in which the loss of hearing for high notes is marked.
The Importance of Statistics in Psychiatry
Authors: Penrose L. S. 
Published: July 2019

The paper gives an outline, with examples, of various statistical methods which may be of special use in psychiatry. (1) Actuarial data.—The simple accumulation of accurate figures on the ages of patients, their diagnoses and length of stay in hospital or under treatment for mental illness is of great value in understanding the scope of psychiatric problems. The age and sex incidences which correspond to different disease groups are very characteristic. Such material has value in the estimation of the results of therapeutic experiments but special methods have to be devised, as there is no exact prototype in standard vital statistics or in work on therapeutic trials. (2) Biometric techniques.—Knowledge of ordinary statistical practice guards against elementary errors and aids in establishing significance or otherwise of metrical deviations from the normal found in mentally ill subjects. Also the range of variations may be much more marked in abnormal than in normal groups. Furthermore, abnormal reactions in themselves may be characterized by either too much or too little variety, i.e. by scatter or by stereotypy. Discrimination between normal and abnormal reaction can be based on a single quantitative measurement, on difference in variance or on a compound measurement, i.e. pattern or profile. The discriminative approach has advantages over other methods because in this approach the initial factors are concrete and based on known classes such as males and females, children and adults, special clinical types, &c. (3) Genetical analysis.—Actuarial data can be useful in genetic studies by leading to estimation of population frequency of genes and consanguinity rates. Moreover, combined clinical and genetical observations can reveal the existence of new clinical entities.
Some Recent Advances in the Study of Carbohydrate Degradation in the Mouth
Authors: Hartles R. L. 
Published: July 2019

The metabolism of carbohydrates in the oral environment is discussed.Manometric methods are very suitable for the study of carbohydrate breakdown in the mouth, only small amounts of material being required. Results of the overall metabolic products can be obtained as also a knowledge of particular enzymic processes.The use of enzyme inhibitors to reduce acid production in the mouth is discussed briefly.
Obesity [Abridged]
Authors: Hopkins Philip 
Published: July 2019

Dr Philip Hopkins defines obesity and describes its incidence in his general practice. He stresses the importance of dealing with underlying psychological factors in the treatment of the condition. Dr A A Lewis discusses hormonal influences and advocates a high protein diet as being an acceptable means of achieving weight reduction. Professor John Yudkin shows that a low protein diet is impracticable, and stresses the importance of physical activity in the treatment of obesity. He advocates a low carbohydrate diet with unrestricted fat and protein.
Influence of Acid-Base Balance on Efficacy and Toxicity of Drugs
Authors: Milne M D 
Published: July 2019

Changes in acid-base balance have a profound influence on many aspects of the action of drugs. This is illustrated by data on the absorption of drugs from the stomach and intestine, in changes in distribution of drugs between plasma and cells, and the effect of change in urinary pH. As a general principle, these changes in the pharmacology of weak acids and bases are governed by physicochemical principles, which influence the proportion of the ionized and unionized components according to the pH of the medium and also to the peculiar property of biological membranes which allow the free passage of the lipoid-soluble unionized component and impede transfer of the water-soluble ionized fraction. Lipoid-soluble weak acids are excreted at higher clearances in alkaline urine, and conversely weak bases in acid urine. This is shown to be of practical importance in the treatment of poisoning, in the diagnosis of addiction to drugs and in studies of drug metabolism. In general, the excretion of natural metabolites is less likely to be influenced by urinary pH, as these substances are usually less lipoid-soluble than many widely used drugs. pH-dependent excretion is, however, of practical importance in relation to the urinary content of many indolic metabolites and also in the excretion of pigments derived from the degradation of hæmoglobin. Urobilinogen excretion is certainly pH-dependent, a higher clearance rate occurring in alkaline urine. However, work is necessary to decide whether some of the porphyrins also show this important physiological property.
The Dawn of State Medicine in Britain
Authors: McConaghey R M S 
Published: July 2019

Dr R M S McConaghey traces the development of State control in the provision of medical services and also describes the rise in status of the general practitioner, from the early apothecary-surgeons. Mr Paul Vaughan describes the history of the British Medical Association and its development from the Provincial Medical and Surgical Association, founded by Sir Charles Hastings. He considers the relationship between the BMA and the Government, both in the past and present.
Developmental Pædiatrics
Authors: Holt K S 
Published: July 2019

Dr K S Holt defines the variety of neurologicalresponses which can be elicited in the newbornbaby and considers their importance in diagnosingdelay in development or abnormalities of thenervous system. Dr Mary D Sheridan describes her finely developedmethods and ingenious devices for testingchildren down to the age of 6 months. Dr Margaret Pollak outlines the advantages ofa developmental pediatric clinic in general practiceand quotes examples of how this has helpedher own patients.
Reduced gray matter volume in patients with retinal detachment: evidence from a voxel-based morphometry study
Authors: Li Biao , Liu Yu-Xin , Li Hai-Jun , Yuan Qing , Zhu Pei-Wen , Ye Lei , Su Ting , Shi Wen-Qing , Lin Qi , Min You-Lan , Xu Xiao-Wei , Shao Yi 
Published: July 2019

BackgroundWe know little about the pathogenesis and diagnosis of retinal detachment.PurposeTo assess spontaneous changes in the cerebral cortex of patients with retinal detachment using voxel-based morphometry and to explore the relationship between retinal detachment and clinical behavioral performance.Material and MethodsPatients (14 men, 6 women; average age = 49.15 ± 10.32 years) with rhegmatogenous retinal detachment (duration of 24.05 ± 19.61 days) and 20 matched healthy controls were recruited. All participants underwent repeated functional magnetic resonance imaging scans. The original three-dimensional T1 brain images were analyzed using voxel-based morphometry and whole brain white matter volume and whole brain gray matter volume were compared with those of the control group. A receiver operating characteristic (ROC) curve was used to classify the mean gray matter volume values of the patients with retinal detachment compared with the controls.ResultsCompared with the controls, whole brain gray matter volume was significantly reduced in patients with retinal detachment, as evidenced by changes in the right inferior frontal gyrus, right superior temporal gyrus, right anterior cingulate gyrus, and right cuneus. In addition, the posterior lobe of the cerebellum, left hippocampus, left cingulate gyrus, and left middle temporal gyrus were also obviously atrophied. Furthermore, whole brain white matter volume of the patients with retinal detachment showed a slight reduction. The ROC curve analysis of each brain region showed that the accuracy of the area under the curve was high.ConclusionWe proved that patients with retinal detachment had unusual changes in the gray matter volume and white matter volume in vision-related brain regions, which could reveal potential pathological mechanisms of retinal detachment.