bluuebunny/crossref_metadata_2025_split huggingface dataset:
Routes of Absorption in Hydronephrosis: Experimentation with Dyes in the Totally Obstructed Ureter
Authors: Morison Duncan M. 
Published: July 2019

In hydronephrosis the contents of the renal pelvis are constantly being changed. The exact mode of the interchange is still obscure. With the hope of obtaining some evidence of this absorption, a series of experiments has been carried out, introducing dyes at various periods in total hydronephrosis. The findings of previous experimental work on the subject are conflicting. Two views are held; one, that absorption occurs solely through the tubular system, and the other, that there is a direct outflow from the renal pelvis into the venous system. In the present work only such an amount of dye was introduced in each instance as to be well within the pelvic capacity of the type of kidney (rabbit). The factor of positive pressure forcing the dye into abnormal channels was thus reduced to a minimum. Two groups of experiments were undertaken. In Group I, the dye was introduced at the outset of the hydronephrosis, and in Group II the dye was introduced at varying periods in the course of an established hydronephrosis. The results obtained would indicate that in total hydronephrosis there are two routes of absorption from the renal pelvis, i.e., lymphatic and tubular. At the outset of complete ureteral obstruction there ensues for the first two or three days an active lymphatic absorption from the walls of the renal pelvis and ureter. After about the third day, tubular absorption commences and continues more actively than the lymphatic. If, however, dye is not introduced till the third day of a hydronephrosis, there is rapid tubular absorption but no lymphatic absorption. With longer periods of hydronephrosis the dye is drawn up the tubule system as far as the convoluted tubules. The further absorption of dye into the general system has not yet been obtained.
The Place of Operations upon the Sympathetic System in the Treatment of Poliomyelitis
Authors: Ogilvie W. H. 
Published: July 2019

Introduction: Revived interest in sympathetic surgery originated in orthopædics. Royle's theories and operations. Their trial, failure and final abandonment. Value of sympathetic operations widely investigated; while finality has not been reached they have proved effective for three main purposes: (1) Relief of pain especially in bladder diseases. (2) Removal of inhibition and sphincteric spasm in alimentary, anal and bladder diseases. (3) Production of vaso-dilatation in ( a) vaso-spastic diseases; ( b) vaso-degenerative diseases; ( c) conditions not due to arterial disease in which increased blood supply is beneficial. Poliomyelitis falls into the last group.—Cause of poor blood supply uncertain;? lack of function;? upset of some reflex;? paralysis of vaso-dilators. Two problems arise, both of which may be treated by operations on the sympathetic: (1) The cold, blue limb, which develops chilblains, sores, or even deep ulcers every winter, often stopping treatment and requiring patient to be confined to bed. (2) The limb with considerable and rapidly increasing shortening. Sometimes these limbs show a fair return of power, and were it not for the heavy boot made necessary by the shortening, the patient could be made to walk well. Method of attack.—(1) Periarterial sympathectomy; (2) ramisectomy; (3) ganglionectomy. Physiological basis of each. Criticism of (1) and (2). Details of the operation for ganglionectomy.—Alternative approaches and their advantages. The immediate and late results of the procedure. Five cases discussed briefly.
The Significance of Small Measurements in Mental Disorder
Authors: Lovell Clement 
Published: July 2019

Measurements must be outside the limits of experimental error. Clinically it is seldom possible to make a series of measurements of the same material. Hence the accuracy of a method must be previously determined in the laboratory. Small degrees of physical abnormality have an importance in mental disease which they may not possess in the wards of a general hospital. Examples discussed: Latent jaundice; mild degrees of uræmia; lymphocytosis.
Plague: Modern Preventive Measures in Ships and Ports
Authors: White C. F. 
Published: July 2019

Maritime quarantine, introduced in the fourteenth century in an endeavour to prevent the spread of plague. Though the system failed to achieve its object, and was expensive and restrictive to sea-borne commerce, it survived for over 500 years, presumably because, in the absence of knowledge of the ætiology of plague, no method of procedure more likely to be successful could be devised. This country acknowledged the failure of quarantine as a preventive measure in the middle of last century, and substituted the medical inspection of ships on arrival, though the last Quarantine Act was not repealed till 1896. Nevertheless it was not till the discovery of the rôle of the rat and the rat-flea in the spread of plague that it was possible to establish plague-preventive measures on a sound scientific basis. It is now recognized that a Port Health Authority must not only take steps to detect plague, human or rodent, afloat or ashore, at the earliest possible moment, but must eliminate conditions in ships and in shore premises which are conducive to the development of an epizoötic. Though here, and in other countries with an enlightened Public Health Administration, practice has long been ahead of legislation, the International Sanitary Convention of 1926 has now established throughout the world a large measure of uniformity in measures designed to prevent the spread of the more dangerous epidemic diseases by overseas trade, and the Port Sanitary Regulations 1933 have brought quarantine legislation in this country up to date. For the detection of plague every ship arriving from a plague-infected port is medically inspected on arrival, but even if there is no evidence of plague-infection on board, such ships are examined daily by a rat-officer until the discharge of cargo is complete. Dead rats found and live rats trapped are bacteriologically examined. If a rat is reported to be infected the vessel is fumigated at once. The discharge of cargo is then continued under supervision, and when the ship is empty she is fumigated again. Shore premises, particularly those in the immediate vicinity of the berths of ships from plague-infected ports, are systematically searched for dead rats, and live rats are trapped. If evidence of plague-infection is found, energetic measures of rat destruction are at once instituted over a wide area. The International Sanitary Convention requires all foreign-going ships to be inspected every six months as to the number of rats on board. If a ship is not so maintained as to keep the rat population down to a minimum she must be deratized. If, after deratization, ships are to remain free from rats, they must be rat-proofed. Similarly ashore, rat-proofing is the only rat-repressive measure of permanent value. The measures usually adopted to prevent the passage of rats between ships and shore are of limited value. Finally, a rat-flea survey is of value in estimating the susceptibility of a port to infection.
Metastatic Tumours of the Brain
Authors: Elkington J. StC. 
Published: July 2019

Metastatic tumours of the brain are comparatively common, and constitute about 20% of all intracranial tumours. They may be derived from primary growths in any part of the body, but the lung and the breast are the most important sources. In most cases the tumours are multiple and blood-borne, and originate at the junction of the grey and white matter or in the central grey masses. More rarely a diffuse invasion of the meninges is encountered. Clinically they are characterized by a sudden or rapid onset, in middle-aged persons, of symptoms of which the most striking are intense and intractable headache out of proportion to the degree of intracranial pressure, symptoms of destruction of conducting pathways, and epileptic episodes. Wasting is severe, and the progress of the disease rapid. Although cerebral manifestation may precede any obvious evidence of the primary growth, symptoms suggestive of primary disease elsewhere can usually be elicited and its presence confirmed by special investigations, of which X-ray examination of the chest is most valuable. Treatment should be confined to those cases which experience pain, and should consist of an extensive decompression at the site of the clinical localization.
A Therapeutic Trial of a Raw Vegetable Diet in Chronic Rheumatic Conditions
Authors: Hare D. C. 
Published: July 2019

Twelve cases of chronic rheumatism have been treated on a raw vegetable diet for periods of two weeks, followed by a modified diet for further periods. No other method of treatment has been used during the period of observation. Pain has been relieved in ten cases and those cases in which there were muscular pain and stiffness with simple effusions into the joints have benefited most. Cinematograph records of the progress have been made. The immediate results obtained appear to be due to the low sodium content of the diet; other factors have not been excluded.
Vinyl Ether for Dental Anæsthesia
Authors: Goldman Victor 
Published: July 2019

Properties: Vinyl ether, CH2:CH2:O:CH2:CH2, a volatile liquid. Lipoidsoluble but highly inflammable. Toxicity.—Has little effect on liver function; overdoses produce respiratory paralysis, but not cardiac paralysis. Indications.—Replaces ethyl chloride for short operations, and can be added to gas and oxygen instead of ether or chloroform. Is a safe and portable anæsthetic for the general practitioner. Administration.—Open method convenient, but not very satisfactory, a closed method produces better anæsthesia. Special inhaler described and illustrated. Vinyl ether is obtainable in ampoules of 3 c.c., a sufficient quantity for the average case. Induction is rapid; signs of anæsthesia described. Patient's colour remains excellent. Apparatus required when vinyl ether is to be added to gas-and-oxygen.
Observations on Genito-Urinary Tuberculosis
Authors: Carver James 
Published: July 2019

Early and reliable diagnosis is obtained by cultural methods. Pyelographic evidence of renal destruction is necessary as a rule to supplement the positive laboratory findings before resorting to nephrectomy. Bilateral renal tuberculosis should not be diagnosed on the findings of cystoscopy alone. Nephro-ureterectomy is the ideal operation. It prevents the prolongation of the bladder symptoms and the breaking-down of the operation wound and the risk of another operation for the removal of the ureter, not forgetting the danger of infection of the other kidney. Bad results are probably due, in the case of poor patients, to economic and sociological factors which interfere with restoration to health after operation. Genito-urinary tuberculosis is to be regarded not as a localized disorder but as a manifestation of a generalized disease, a fact which necessitates a guarded prognosis and prolonged after-treatment.
Malignant Degeneration of Gastric Ulcer
Authors: Finsterer H. 
Published: July 2019

Malignant degeneration is the most serious complication of gastric ulcer. Its recognition is difficult both in the early stage and in advanced cases in which only the evidence of a previous ulcer-cavity, and the radiating folds of the mucous membrane indicate progressive development of carcinoma from an original ulcer. It is impossible to say how often gastric ulcer becomes malignant; one can only state the frequency of ulcer-carcinoma, found in gastric resections. One hundred and forty-one personal cases of ulcer-carcinoma are recorded, and are divided into three groups. Group I: 41 which were diagnosed clinically and at operation as cases of ulcer, but in which histological examination showed incipient cancer. Group II: 55 diagnosed clinically as cases of ulcer, but in which a diagnosis of ulcer-carcinoma was made during operation and afterwards histologically confirmed. Group III: 45 diagnosed both clinically and macroscopically (from the typical folding of the mucous membrane) as cases of ulcer-cancer, in which the cancer had entirely overgrown the ulcer. Therefore in the series of 532 resections for gastric ulcer the frequency of ulcer-carcinoma was 20.9%, or 15.2% if the third group is omitted. In a series of 718 resections for gastric cancer, the frequency of ulcer-carcinoma was 19.6% (or 14.2% if the third group is omitted). The mortality in simple two-third resection of the stomach is low (four deaths in 99 cases = 4%). When the pancreas, liver, colon, or œsophagus, is involved, the resection mortality is high (14 deaths in 42 cases = 33.3%), but even in these cases the operation is justifiable because permanent cures were achieved in a number of cases. The prognosis in cases of ulcer-cancer is very grave. In many cases, judging from the author's own experience, patients suffering from incipient ulcer-cancer—only histologically diagnosed as cancer—die from liver metastases, in spite of radical resection. It will thus be seen that the end-results of resection for ulcer-carcinoma are actually worse than those of resection for primary carcinoma. A. Ulcer-cancer: In Group I, 35 cases were operated on before 1933, and in 18 of these (51.4%) the patients have been free from symptoms for more than five years; in Group II, 27 cases were operated on before 1933, and in four of these (14.8%) the patients are still symptom-free. In Group III, out of 37 cases operated on, only two patients (5.4%) have been symptom-free for the same period. B. Primary cancer: Out of 260 cases of resection for primary cancer before 1933, 77 patients (29.6%) are permanently cured. If the ulcer-cancer is so far advanced that the diagnosis can be made clinically, or during operation, the prognosis is extremely bad (permanent cures having been only 9.3% in the series). In cases of gastric ulcer the best plan is to carry out resection before malignant degeneration begins. The result would then be that not merely 51% but at least 90% of the patients would be alive and well after five years.
A Comparative Study of the Innervation of the Gum
Authors: Stewart D , Lewinsky W 
Published: July 2019

In this paper we give a comparative study of the innervation of the connective tissues of the gum underlying the epithelium. Our material was taken from carnivores, rodents, insectivores and men. The fibres form superficial and deep plexuses and leashes, and specialized nerve-endings are also present. The types of specialized nerve-endings seen have been:— (1) Coils which are situated either in the intra-papillary zone of the deeper connective tissue. (2) Ruffini-like nerve-endings and convoluted fibres the presence of which in the gum has not been previously described.
The Diagnostic Value of Hysterography
Authors: Davis Albert 
Published: July 2019

Object of paper.—Clarification of position concerning clinical value of procedure. Conflicting views. Review of routine examination of all cases investigated during the past two years. Historical.—Suggested by Cary (1914) and Rubin (1915), made practicable by the invention of lipiodol—applied Heuser (1924). Technique.—Instruments employed, anæsthesia, X-ray figures, screening. Material.—Uterine fibroids and carcinomas, extra-uterine tumours and cysts, placental remains and polypi, moles, &c. Correlation with operative results. Physiology.—Normal shapes, sizes, and positions. Pseudo filling-defects and malformations. Pathology.—Appearances in various conditions. Correlation with specimens and radiography of same. Fallacies and contradictions. Conclusions.—Method of value in diagnosis of placental remains may avoid diagnostic curettage in carcinoma of body; by localization of fibromata may allow of prediction of myomectomy, &c. But fallacies numerous and much more experience required to make diagnosis so accurate as to be of much real routine value.
Dental Caries in Norwegian Children during and after the Last World War. A Preliminary Report
Authors: Toverud Guttorm 
Published: July 2019

A preliminary report is submitted on the occurrence of dental caries in Norwegian children, during and after the World War.Dental examinations of 8,000 to 9,000 school children from different parts of Norway have been carried out each year from 1940 to 1948. It is concluded from the statistical results of the investigation that the caries frequency decreased steadily from year to year during the war. The reduction in the number of carious tooth surfaces per child from the beginning of the war to the lowest number some time after the war ended amounts to 50 to 75%.A study has also been undertaken on 600 to 700 children, 2½ to 7 years old. The results in this younger group show even a greater reduction.In both groups the decrease is statistically significant.From 1946 the caries frequency has increased again in the school children as well as in the pre-school children. In both groups the increase is statistically significant.The turn of the caries curve after the war differs according to the age-group.The cause of the decrease in caries frequency during the war and the cause of the increase after the war is discussed. Based on the rationing of the various food articles our tentative conclusion is that the decrease may be attributed to the lowering in consumption of refined carbohydrates and the increase in consumption of more natural foods, i.e. protective foods. This may have resulted in an increased resistance of the teeth and a reduction in the local factors which produce decay.More detailed studies of the change in caries frequency as well as of the change in food consumption and habit of living during and after the war are necessary before a definite conclusion can be drawn. Such studies are being continued.
Open Access to Investigational Procedures for the General Practitioner
Authors: Wheatley David 
Published: July 2019

Dr David Wheatley produces figures to show that, in his area of practice, open access to pathology at one large hospital has resulted in less work being undertaken than at another large hospital, where such access is unavailable. He stresses the necessity for open access to such services, including X-rays and ECGs, if a high standard of general practice is to be maintained. Professor R E Steiner, although agreeing with the concept of open access for the general practitioner, believes that at present this should be limited by the facilities available. He describes such a service which has been made available to general practitioners at Hammersmith Hospital for diagnostic X-rays, and stresses the importance of personal consultation between specialist and general practitioner. Dr D Stark Murray describes the system of complete open access to the pathology laboratory, which has been in operation at Kingston Hospital over the past twenty-five years. He shows the use which has been made of the service by local general practitioners and stresses that this is an essential part of the health service.
Psychotropic Drugs (2) Interaction between Monoamine Oxidase (MAO) Inhibitors and other Substances
Authors: Sjöqvist Folke 
Published: July 2019

Monoamine oxidase inhibitors (MAOI) in clinical use have an irreversible action on MAO, and this persists until the enzyme has been resynthesized. The effects of small daily doses of MAOI are therefore cumulative. The biochemical effects of these drugs will involve several substrates of MAO, e.g. dopamine, tyramine, serotonin and, to a lesser extent, noradrenaline and adrenaline.MAO probably regulates the metabolism of catecholamines and serotonin in tissues, while catechol-O-methyltransferase is responsible for the metabolism of circulating noradrenaline and adrenaline.Certain pharmacological effects of MAOI are related to the accumulation of monoamines in various tissues that follows the decrease of intraneuronal deamination. Among these effects are reversal of the reserpine syndrome in animals and augmentation of the pharmacological action of monoamines. Other effects are unrelated to the inhibition of MAO, e.g. immediate desynchronization of EEG and initial pressor effects.MAOI may potentiate or change the action of several other drugs and even certain foods. The mechanisms involved are usually reasonably predictable from animal experiments. Substrates of MAO, e.g. dopamine and tyramine, evoke augmented and prolonged effects in patients treated with MAOI. This is partly due to an impaired metabolism of the circulating amines. In addition, inhibition of intestinal and hepatic MAO largely increases the absorption of tryamine from cheeses and other foods. Usually innocuous amounts of tyramine may therefore cause hypertensive reactions in patients treated with MAOI. Indirectly acting sympathomimetic amines, such as amphetamines, ephedrine and MAOI with amphetamine-like properties, can be potentiated, because they may release increased amounts of nor-adrenaline from sympathetic nerve endings after MAO inhibition. The effects of any amine, whether a substrate of MAO or not, may be enhanced by MAO inhibitors producing postganglionic block. This is due to ‘denervation’ supersensitivity of adrenergic receptors.Harmful pharmacological interaction is also possible between MAO inhibitors and agents which release (reserpine) or replete (amine precursors, e.g. L-DOPA in broad beans) monoamines centrally and peripherally. Drugs that sensitize adrenergic and tryptaminergic receptors to the action of monoamines, e.g. imipramine-like compounds, may be greatly potentiated by MAO inhibitors. The anti-hypertensive effects of thiazides and ganglion-blocking agents may be enhanced by MAOI. A few drugs are known to exert prolonged effects in occasional patients treated with MAOI, e.g. pethidine, phenothiazines and pentobarbital. MAOI may possibly decelerate the metabolism of these compounds by a nonspecific inhibition of liver microsomal enzymes. Finally, a great number of agents have been found empirically to evoke augmented effects after inhibition of MAO, e.g. insulin and anti-Parkinson drugs.
Prescribing Habits in General Practice [Abridged]
Authors: Linnett Michael 
Published: July 2019

Dr M Linnett considers the factors which influence prescribing habits and outlines the questions which should be asked before committing a patient to a new drug. Mr A Howells describes the problems of the chemist dispensing doctors' prescriptions, showing how confusion can arise and how it can be avoided. Professor J R Trounce reports on a questionnaire sent out to 100 Guy's graduates to ascertain their sources of information on new drugs and their views of further education. He makes a plea for some means of more authoritative information about new drugs.
Sleep
Authors: Wheatley David 
Published: July 2019

Dr David Wheatley discusses the variations of individual sleep requirements, and classifies five main causes of insomnia: physical, physiological, psychological, iatrical and idiopathic. The various aspects of treatment are discussed and the use of sedative drugs illustrated. Dr Ian Oswald describes the two types of sleep, paradoxical and orthodox, and the effects of drugs upon them. He emphasizes the fact that all the common drugs of dependence suppress paradoxical sleep. Professor H Hediger considers the sleep patterns in the animal world and shows how these are adapted to the survival of individual species. Appreciation of the past and the future, which animals do not possess, may be a factor in human sleep disturbances.
The Primary Physician: Generalist or Specialist? [Abridged]
Authors: Yellowlees W W 
Published: July 2019

Dr W W Yellowlees makes out a strong case against the creation of general practitioner ‘specialoids’. He emphasizes the limitations of the specialists' organ-orientation, without the generalized knowledge of the patient as a person and of the influence of his environment on his illness. Dr Paul Sadler takes another point of view and describes the successful division of his housing-estate practice into four specialist departments: Pxediatrics, geriatrics, obstetrics and general medicine. He further details the organization and advantages of his own department, pediatrics.