Internal medicine

Front matter

COPYRIGHT DEPOSm

INTERNAL MEDICINE

BY

Preface

Doubtless there has rarely been a teacher of medicine who has been satisfied with the books which his students have had to use. The large treatises are too long, too rich in information for those entering upon the study of medicine, while many of the shorter works are mere catalogues of facts. It has seemed to the writer, after many years ' teaching, that there was a distinct need both among students and practitioners of a work which should give in compact form the more important facts of the subjects included in the domain of internal medicine. Just as the modern builder rears his frame-work of steel and upon this suspends the walls, the floors and the ornamentation of his building, so the student must outline his subject in his mind, and later add the details. The beauty of the building will depend upon the finish, its strength must lie in the frame-work. The purpose of the present work is to supply the frame-work of internal medicine.

The title has been chosen in recognition of the need of a term which shall denote those subjects left of the older " practice of medicine " when all the specialties have been subtracted from it, those subjects which are, after all, the fundamentals of our study.

The arrangement of the subjects has been dictated by the wish to put the simpler first, and to present something of a logical order of study. The placing of some subjects, such as that of small-pox, among diseases due to animal parasites, is questionable, but in such instances it has seemed well to follow the best leading we have at present, although we may he uncertain of its correctness. The final classification of many of the familiar diseases must long remain doubtful. Syphilis has for years been regarded as surely a bacterial disease and classified accordingly. The recent studies apparently prove the specific organism to belong to the lower orders of the animal kingdom. At any time further investigation may restore the disease to its older position. In like manner the specific agents of scarlet fever, measles, and other exanthemata are assumed to be bacteria, and these diseases are placed accordingly. The eager investigations now going on in so many laboratories may any day give one or more of these diseases a new position. We must act upon our present knowledge, with full consciousness that much of it may tomorrow require revision.

The lack of ilbistration in the current works on our subject has been very striking in this day when photography is so readily available and is so great an aid in the presentation of any subject. It has been a source of pleasure that the publishers have wished to make full use of this aid

V vi

PREFACE and have so heartily assisted the author in his efforts to this end. To the many friends who have loaned their treasures to him, the author renews his thanks. The effort has been made to render due recognition for such assistance.

Especial thanks are due to my friends, Dr. Walter B. James for aid in writing the chapter on Cardiac Arrhythmia, and Dr. Lewis A. Conner for much valuable aid in the preparation of the text.

The Author.

New York, August, 1912.

Contents

I

DISEASES or THE RESPIRATORY TRACT

PAGE

II Diseases of the Mouth 57

Stomatitis 57

Catarrhal Stomatitis 57

Herpetic or Aphthotis Stomatitis 57 vii viii CONTENTS

I PAGB

Ulcerative Stomatitis 57

Parasitic Stomatitis 58

Gan<irenoiis Stomatitis 58

Acute and Chronic Glossitis 59

Geographical Tongue 59

Leukoplakia Buccalis 59

Diseases of the Salivary Glaxds 59.

Disturbance of Secretion 59

Acute Parotitis 59

Chronic Parotitis 60

Von Mikulicz's Disease GO

Diseases of the Pharynx GO

Acute Catarrhal Pharyngitis 60

Chronic Pharyngitis GO

Retropharyngeal Abscess 60

Diseases of the Toxsils 61

Acute Follicular Tonsillitis 61

Suppurative Tonsillitis 62.

Hypertrophy of Tonsils and Adenoid Vegetations 62

Diseases of the Esophagus 63

Acute Esophagitis 63

Ulceration of the Esophagus 63

Spasm of the Esophagus 63

Stenosis of the Esophagus 64

Cancer of the Esophagus 65

Diverticulum of the Esophagus 65

Dilatation of the Esophagus 65

Acute Gastritis 65

Toxic Gastritis 66

Phlegmonous Gastritis 67

Chronic Gastritis 67

Ulcer of the Stomach 69

Cancer of the Stomach = 73

Acute Dilatation of the Stomach 76

Chronic Dilatation of the Stomach 77

Congenital Hypertrophic Stenosis of the Pylorus 79

Hemorrhage from the Stomach 80

Neuroses of the Stomach 81

Sensory Neuroses 81

Secretory Neuroses 82

Motor Neuroses 82

Enteritis 83

Croupous Enteritis 85

Phlegmonous Enteritis 85

Cholera Nostras 85

Diarrheal Diseases of Childhood 86

Acute Intestinal Indigestion 86

Acute Gastro-Enteric Infection 87

lleo-Colitis 87

Intestinal Ulcers 89

ClioU'ra 90

Dysentery 93

Acute Catarrhal Dysentery 93

Acule Specilie Dysentery 94

Amchic Dysentery 94

Diphtlieritic Dysentery 95

Chronic Dysentery 9(5

Ap]iendi('itia 96

Intestinal Ohst ruet ion 102

CONTENTS ix

PAGE

Constipation 107

Enteroptosis 109

Neuroses of the Intestine... 110

Mucous Colitis 112

Cancer of the Intestine 113

Jaundice 115

Obstructive Jaundice 115

Toxemic Jaundice ; 116

Acute Yellow Atrophy of the Liver 116

Disturbances of the Hepatic Circulation 118

Diseases of the Blood-Vessels of the Liver 119

Embolism or Thrombosis 119

Suppurative Pylephlebitis 119

Cirrhoses of the Liver 120

Biliary Cirrhosis 124

Absces's of the Liver 125

New Growths of the Liver 127

Fatty Liver 129

Amyloid Liver 129

Anomalies in Form and Position of Liver 130

Diseases of the Bile-Passages and Gall-Bladder 131

Acute Catarrh of the Bile-Duets 131

Chronic Catarrhal Angiocholitis 131

Suppurative and Ulcerative Angiocholitis 132

Acute Infectious Cholecystitis 132

Cholelithiasis 133

Acute Hemorrhagic Pancreatitis 137

Suppurative Pancreatitis 138

Chronic Pancreatitis 139

Pancreatic Cyst 140

Carcinoma of the Pancreas 140

Pancreatic Calculi 141

Acute General Peritonitis 142

Localized Peritonitis 144

Chronic Peritonitis 146

New Growths of the Peritoneum 147

Ascites 147

III Movable Kidney 151

Congestion of the Kidney 152

Anomalies of Secretion 152

Anuria 152

Hematuria 152

Hemoglobinuria 153

Albuminuria 153

Pyuria 154

Chyluria 154

Lithuria 154

Oxaluria 155

Cystinuria 155

Plio>i)haturia 155

Indicanuria 15G

Uremia 150

Acute Nephritis 160

X CONTENTS

PAGE

Chronic Nephritis 162

Chronic Parenchymatous Nephritis 163

Chronic Interstitial Nephritis 165

Amyloid Disease of the Kidney 168

Cystic Disease of the Kidney 169

Pyelitis 170

Nephrolithiasis 171

Hydronepluosis 173

Perinephritic Absfcss 173 .

Tumors of tlie Kidney 174

IV Diseases of the Pericardium 175

Pericarditis 175

Chronic Adhesive Pericarditis 181

Tuberculous Pericarditis 182

Other Affections of the Pericardium 182

Endocarditis 183

Acute Endocarditis 183

Malignant and Septicemic Endocarditis 185

Chronic Endocarditis 187

Chronic Valvular Heart Disease 188

Mitral Insufficiency 193

Mitral Stenosis. . ."^ 194

Aortic Insufficiency 195

Aortic Stenosis 198

Pulmonary Insufficiency. 199

Pulmonary Stenosis 199

Tricuspid Insuffioieiicy „ 200

Tricuspid Stenosis 201

Combined Valvular Lesions of the Heart 201

Hypertrophy of the Heart 208

Hypertrophy of the Left Ventricle , 209

Dilatation of the Heart 209

Diseases of the Myocardium 211

]Myocarditis 211

Acute Myocarditis 212

Chronic Myocarditis 213

Fatty Heart 213

Neuroses of the Heart 214

Palpitation 214

Tachycardia (Rapid Heart) 215

Bradycardia (Slow Heart) 216

Arrhytliniia 216

Angina I'cetoris 226

Toxic Angina 227

Congenital Defects of the Heart 228

Acute Aortitis 229

Arteriosclerosis 229

Aneurism 232

Aneurism of Ascending Portion of the Arch 234

Aneurism of the Transverse Arch 235

Aneurism of Descending Part of Arch 236

Aneurism of Thoracic and Abdominal Aorta 236

Acute Phlebitis 239

Tlironibosis. 242

1 Icmorrlioids 243

CONTENTS xi

V

PAGE

Anemia 246

Chlorosis 246

Secondary Anemia 247

Pernicions Anemia 248

Leukemia , 249

Splenomyelogenous Leukemia 250

Lymphatic Leukemia 250

Pseudoleukemia 253

Purpura 255

Hemophilia .• . . 257

Morbus ]\Iaculosus Neonatorum 259

Scurvy 259

Infantile Scurvy 260

Status Lymphaticus 262

Diseases of the Suprarenal Bodies 262

Addison's Disease 262

Diseases of the Spleex 263

Movable Spleen 263

Rupture of Spleen 264

infarct and Abscess of Spleen 264

Tumors of Spleen 264

Splenomegaly 264

Polycythemia 266

Congestion 267

Acute Thvroiditis 267

Goitre . . 267

Tumors of the Tliyroid 268

Exophthalmic Goitre 268

Myxedema 271

Cretinism 272

Myxedema 272

Diseases of the Thymus Gland 274

VI Chronic Polyarthritis 276

Muscular Pvheumatism 279

Gout 280

Diabetes Mellitus 284

Diabetes Insipidus 289

Rachitis 290

Achondroplasia 293

Obesity 294

VII Intoxications And ^miscellaneous Diseases

Alcoholism > 296

Opium: Poisoning 299

Morphine Habit 299

Cocaine Poisoning 301

Cocaine Habit 301

Chronic Lead Poisoning 301 xii

CONTENTS

Chronic Arsenic Poisoning 303

Food Poisoning 304

Carbon Monoxide Poisoning 307

Sunstroke 308

Diseases of the :Muscles 309

Myositis 309

Myotonia Congenita 310

Myasthenia Gravis 311

Paraniyocloniis Multiplex 311

Rare Diseases of the Bones and Joints 312