Modern medicine

Front matter

Class.

Book

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Preface

In the present era the practice of medicine includes the study of a number of specialties, such as physical diagnosis, bacteriology, the examination of the gastric contents, the urine, the blood, the feces, etc. Hence it has frequently been necessary for the student to procure separate books upon these topics. For this reason it has appeared advisable for the authors to combine in one volume, as far as possible, the essentials of these branches as applied to Clinical Medicine.

The arrangement of the special topics has been adopted to prevent repetition, to present as concise a description of allied subjects as possible, and to link more closely the various divisions.* Thus, the pathogenic germ of a special disease is considered under the head of Clinical Bacteriology, rendering it unnecessary for one already acquainted with such facts to again read the morphology, the biology, the pathogenesis, etc., when dealing with the description of the disease. But if the reader is unfamiliar with the subject, such facts will be found in the section that deals with the micro-organisms that are of importance in clinical medicine.

A similar course has been followed in regard to physical diagnosis, examination of the sputum, of the stomach contents, of the blood, of the urine, and of the feces. The aim of the authors has been to give the main facts in regard to etiology, pathology, symptomatology, diagnosis, prognosis, and treatment as considered from a modern and generally accepted standpoint. The most modern medical works in English, German, and French have been freely consulted. The authors desire to express their thanks to Mr. Thomas F. Dagney, of W. B. Saunders & Co., for many courtesies extended during the progress of the work.

Philadelphia, September, igoo.

Contents

PAGE

Examination of the Surface of the Body, 19. — Constitutional Peculiarities, 20. — The Decubitus, 21. — The Facies, 22. — Consciousness, 22. — Temperature, 23. — Examination of the Skin, 26. — Eruptions (Exanthemata), 33. — Edema, 34. — Emphysema of the Skin, 35. — Moisture of the Skin, 36. — The Pulse, 37. — Sphygmography of the Radial Pulse, 43.

Examination of the Respiratory Organs, 49. — Physical Diagnosis of the Heart, 77. — Examination of the Arterial System, 91. — Examination of the Abdominal Organs, 92.

PART I.— INFECTIOUS DISEASES. The Continued Fevers 17 1

Simple Continued Fever iyi

Influenza

Enteric or Typhoid Fever jys

Typhus Fever jg6

Relapsing Fever loo

T>engue Ig5

Periodic Fevers !o6

Malaria !g6

Estivo-autumnal Type 202

Exanthemata or Eruptive Fevers 204

Variola (Smallpox) . . ... 213

Varioloid, or Variola Modificata 217

Vaccinia (Cowpox) 219

CONTENTS.

PAGE

Fevers with Marked Local Manifestations 228

Acute Rheumatic Fever . ......... 238

Cerebrospinal Fever . 248

Plague 257

Pertussis 259

Parotitis 261

Infections without Special Classification . . 262

Acute Miliary Tuberculosis 265

Tuberculosis of the Lungs 268

Acute Pneumonic Phthisis 268

Chronic Ulcerative Tuberculosis 270

Fibroid Phthisis 275

Tuberculosis of the Lymph-glands 276

Tuberculosis of the Serous Membranes 277

Tuberculosis of the Alimentary Canal 278

Tuberculosis of the Tongue 279

Tuberculosis of the Stomach 279

Tuberculosis of the Intestines 279

Tuberculosis of the Liver and Pancreas 280

Tuberculosis of the Genito-urinary System 280

Tuberculosis of the Kidney 280

Tuberculosis of the Mammary Gland 281

Tuberculosis of the Brain and Cord 281

Tuberculosis of the Arteries and Heart . 281

Septicemia . 283

Pyemia 285

Anthrax 286

Actinomycosis 287

Miliary Fever 288

Mountain Fever 290

Milk-sickness 290

Leprosy 291

Acute Catarrhal Dysentery . 296

Diphtheric Dysentery 296

Amebic (or Tropic) Dysentery 298

Secondary Dysentery 299

Syphilis , 300

Acquired Syphilis 301

Congenital Syphilis 303

Visceral Syphilis 304

Glanders 304

Foot-and-mouth Disease 306

Hydrophobia 307

Tetanus 309

Weil's Disease ". 310

Malta Fever . ' 31 1

PART II.— DISEASES OF THE CIRCULATION. Congenital Malformations of the Heart 313

Diseases of the Pericardium 314

Pericarditis 314

Acute- Pericarditis 3*4

PAGE

Diseases of the Pericardium (continued) :

Suppurative Pericarditis 318

Chronic Pericarditis 318

Hydropericardium 321

Hemopericardium . , 322

Pneumopericardium 322

New Growths and Parasites of the Pericardium 323

Acute Endocarditis 323

Simple Acute Endocarditis 324

Infective Endocarditis 327

Chronic Endocarditis. — Sclerotic Endocarditis. — Mitral Insufficiency . . 330

Mitral Stenosis 332

Aortic Insufficiency 334

Aortic Stenosis 336

Tricuspid Insufficiency 338

Tricuspid Stenosis 339

Pulmonary Incompetence 339

Pulmonary Stenosis 340

Combined Valvular Lesions 342

Effects of Valvular Disease 342

Hypertrophy of the Heart " . 344

Dilatation of the Heart 347

Acute or Simple Dilatation 347

Chronic Dilatation 348

Diseases of the Myocardium 350

Fatty Infiltration . . 350

Parenchymatous Degeneration 351

Fatty Degeneration 351

Acute Myocarditis 352

Chronic Interstitial Myocarditis 353

Amyloid Disease 353

Aneurysm of the Heart 354

Rupture of the Heart . 355

New Growths and Parasites 355

Neuroses of the Heart 356

Arrhythmia 356

Palpitation 356

Irritable Heart 357

Tachycardia 358

Bradycardia or Brachycardia 358

Angina Pectoris 359

Diseases of the Arteries 361

Infiltrations and Degenerations 361

Arteritis, or Inflammation of the Arteries 361

Acute Arteritis : . 361

Arteriosclerosis 362

Aneurysm of the Abdominal Aorta 369

PART III.— DISEASES OF THE RESPIRATORY SYSTEM. Diseases of the Nose . . 370

Acute Rhinitis 370

Chronic Rhinitis 371

Diseases of the Larynx 372

Acute Laryngitis 372

Chronic Laryngitis 372

I O CONTENTS.

PAGK

Diseases of the Larynx (continued):

Edema of the Larynx 373

Laryngismus Stridulus 374

Spasm of the Larynx in Children 374

Spasm of the Larynx in Adults 375

Cr o u P 375

Diseases of the Bronchi 376

Simple Acute Bronchitis 376

Fibrinous Bronchitis 379

Chronic Bronchitis 380

Bronchiectasis 383

Bronchial Asthma 386

Hay-fever 388

Diseases of the Pulmonary Structure 390

Pseudohypertrophic Emphysema 390

Vesicular Emphysema , 390

Pulmonary Atelectasis 392

Atelectasis of the New-born 393

Acquired Atelectasis 393

Pulmonary Hemorrhage 394

Bronchopneumonia 397

Chronic Fibroid Pneumonia 401

Congestion of the Lungs 403

Pulmonary Edema 404

Gangrene of the Lung 405

Abscess of the Lung 405

Pneumonokoniosis . 406

Syphilis of the Lungs 407

New Growths of the Lungs 409

Parasites 410

Diseases of the Pleura 410

Dry, Fibrinous, or Plastic Pleurisy 410

Serofibrinous Pleurisy - 412

Atypical Forms 416

Purulent Pleurisy ; Empyema 416

Special Varieties of Pleurisy 419

Chronic Pleurisy 424

Pneumothorax 425

Hydrothorax 427

Hemothorax 428

Tumors of the Pleura 429

Echinococcus of the Pleura 430

Diseases of the Mediastinum 430

Inflammation of the Mediastinum 430

Abscess of the Mediastinum 431

Tumors of the Mediastinum 432

PART IV.— DISEASES OF THE DIGESTIVE TRACT. Diseases of the Mouth 434

Catarrhal Stomatitis 434

Ulcerative Stomatitis 435

Aphthous Stomatitis . 435

CONTENTS. I I

PAGE

Diseases of the Mouth (continued):

Parasitic Stomatitis 436

Mercurial Stomatitis 437

Gangrenous Stomatitis 438

Diseases of the Tongue 439

Acute Glossitis 439

Chronic Glossitis 439

Diseases of the Salivary Glands 440

Hypersecretion 440

Xerostoma , 440

Inflammations of the Salivary Glands 440

Diseases of the Tonsils 441

Acute Tonsillitis 441

Acute Follicular Tonsillitis 441

Suppurative Tonsillitis 443

Chronic Tonsillitis . 444

Diseases of the Pharynx 445

Acute Pharyngitis '.' 445

Chronic Pharyngitis 440

Retropharyngeal Abscess 446

Diseases of the Esophagus ............ . .-~ 447

Acute Esophagitis 447

Chronic Esophagitis . 448

Spasm of the Esophagus . . , 448

Stricture of the Esophagus 449

Tumors of the Esophagus 450

Dilatation of the Esophagus 451

Rupture of the Esophagus 451

Diseases of the Stomach 452

Gastritis 452

Simple Acute Gastritis 452

Severe Acute and Toxic Gastritis 453

Phlegmonous Gastritis 455

Chronic Gastritis 456

Dyspepsia 458

Malignant Tumors of the Stomach . . 465

Carcinoma 465

Sarcoma 469

Nonmalignant Tumors of the Stomach 470

Foreign Bodies in the Stomach 470

Hemorrhage from the Stomach 470

Dilatation of the Stomach, Displacements of the Stomach, and Other

Deformities 471

Gastrectasis . . . . 471

Gastroptosis 473

Other Displacements 474

Neurosis of the Stomach 474

Gastralgia 474

Bulimia 474

Neurosis of Secretion 474

Peristaltic Unrest of the Stomach 475

Diminished Peristalsis of the Stomach, or Atony 475

Diseases of the Intestines 475

Intestinal Catarrh ... 475

Acute and Chronic Catarrhal Enteritis 475

Croupous Enteritis 479

Phlegmonous Enteritis 479

PAGE

Diseases of the Intestines (continued):

Enteritis of Children 480

Acute Dyspeptic Diarrhea 480

Cholera Infantum 481

Acute Enterocolitis 481

Mucous Enteritis 482

Intestinal Ulceration 483

Cholera Morbus 484

Enterorrhagia . . . '. 485

Enteroptosis 486

Chronic Appendicitis 493

Relapsing Appendicitis . . 493

Intestinal Obstruction 495

Intussusception of the Bowels 498

Hemorrhoids 500

Tumors of the Intestines 501

Diseases of the Peritoneum 504

Acute General Peritonitis , 504

Acute Local Peritonitis 508

Chronic Peritonitis (Adhesive Peritonitis) 508

Ascites 510

Tumors of the Peritoneum 512

Cysts of the Peritoneum . 514

Diseases of the Liver 515

Displacements of the Liver 515

Active Congestion of the Liver 515

Passive Congestion of the Liver 517

Fatty Liver 518

Amyloid Disease of the Liver 520

Atrophic Cirrhosis of the Liver 521

Biliary Cirrhosis 525

Congestion Cirrhosis . . , . 525

Cirrhosis due to Malaria 526

Syphilitic Cirrhosis 526

Hypertrophic Cirrhosis 527

Acute Yellow Atrophy of the Liver . 529

Abscess of the Liver 531

Benign Tumors of the Liver 534

Malignant Tumors of the Liver 535

Diseases of the Biliary Passages . , 538

Obstructive Jaundice 538

Toxemic Jaundice 53^

Catarrhal Jaundice 53^

Icterus Neonatorum 539

Suppurative Cholangitis 54°

Cholelithiasis; Gall-stones 54 1

Diseases of the Hepatic Vessels 546

Diseases of the Portal Vein 546

Inflammation of the Portal Vein. — Pylephlebitis 547

Acute Pylephlebitis 547

Chronic Pylephlebitis ' 54^

Diseases of the Pancreas , 549

PAGE

Diseases of the Pancreas (continued) :

Inflammation of the Pancreas 549

Acute Hemorrhagic Pancreatitis .*..... 549

Purulent Pancreatitis (Abscess of the Pancreas) 549

Gangrenous Pancreatitis 550

Chronic Indurative Pancreatitis 551

Tumors of the Pancreas 551

Pancreatic Cysts 552

Pancreatic Calculi 553

Hemorrhage into the Pancreas ' 553

Fat Necrosis of the Pancreas 554

Rupture of the Pancreas 555

PART V.— DISEASES OF THE KIDNEYS. Acute Congestion - . . . 556

Passive Congestion 55^

Acute Diffuse Nephritis 558

Chronic Interstitial Nephritis . 568

Amyloid Disease of the Kidney 571

Suppurative Nephritis 572

Perinephritic Abscess 576

Fatty Degeneration and Fatty Infiltration of the Kidney 576

Pyelitis and Pyelonephritis 576

Hydronephrosis , 579

Tumors of the Kidney . 580

Cysts of the Kidney 582

Malformations and Malposition of the Kidney 582

Malformations 582

Floating Kidney . . 583

Renal Calculi 583

Uremia 587

PART VI.— CONSTITUTIONAL DISEASES. Diabetes Mellitus 590

Diabetes Insipidus 595

Chronic Rheumatism 597

Gonorrheal Arthritis 598

Muscular Rheumatism 599

Rickets 600

Arthritis Deformans 602

Gout 604

Lithemia 607

Obesity 609

Osteomalacia 610

Pulmonary Hypertrophic Osteoarthropathy 610

Osteitis Deformans 61 1

Part Vii.— Diseases Of The Blood And Of The Ductless Glands. Page

Anemia . . 612

Secondary Anemia 612

Chlorosis 617

Pernicious Anemia 619

Leukemia 621

Hodgkin's Disease 625

Splenic Anemia 629

Addison's Disease 630

Scurvy , 633

Infantile Scurvy 635

Purpura 636

Symptomatic Purpura 636

Arthritic Purpura 637

Purpura Hsemorrhagica 637

Hemophilia 638

Myxedema 640

Adult Myxedema 640

Sporadic Cretinism 642

Operative Myxedema 642

Exophthalmic Goiter . 643

Acromegaly 645

PART VIII.— DISEASES OF THE NERVOUS SYSTEM. Diseases of the Nerves 647

Neuritis 647

Localized Neuritis 647

Brachial Neuritis 648

Sciatica . 649

Multiple Neuritis 650

Endemic Neuritis . 653

Diseases of the Cranial Nerves 654

Diseases of the Olfactory Nerve 654

• Diseases of the Optic Nerve 654

Optic Neuritis 654

Paralysis of the Ocular Nerves 655

Diseases of the Fifth Nerve (Trifacial) 655

Diseases of the Seventh Nerve (Facial Paralysis; Bell's Palsy) . . . 656

Diseases of the Auditory Nerve 657

Diseases of the Glossopharyngeal Nerve 657

Diseases of the Pneumogastric or Vagus Nerve 657

Diseases of the Spinal Accessory Nerve - 658

Diseases of the Hypoglossal Nerve 658

Neuralgia 658

Diseases of the Spinal Cord 660

Acute Spinal Meningitis . . . 660

Chronic Spinal Meningitis 662

Hypertrophic Cervical Pachymeningitis 663

Hemorrhage into the Spinal Membranes 664

Anemia and Hyperemia of the Spinal Cord ....'. 666

Paralysis from Lessened Atmospheric Pressure 1 666

Hemorrhage into the Spinal Cord 667

CONTENTS. I 5

PAGii

Diseases of the Spinal Cord (continued) :

Acute Anterior Poliomyelitis 668

Acute Myelitis 670

Disseminated Myelitis 672

Chronic Myelitis 673

Acute Ascending Paralysis 675

Locomotor Ataxia 676

Primary Lateral Sclerosis 680

Posterolateral Spinal Sclerosis 681

Putnam and Dana's Combined Sclerosis of the Lateral and Posterior

Columns 682

Pellagra 683

Hereditary Ataxic Paraplegia 683

Amyotrophic Lateral Sclerosis 684

Hereditary or Infantile Forms of Progressive Atrophy of Spinal Origin 685

Progressive Muscular Atrophy of the Heubner-Striimpell Variety . . . 686

Disseminated Sclerosis 686

Tumors of the Spinal Cord 688

Syringomyelia 688

Diseases of the Medulla and Pons 690

Progressive Bulbar Paralysis ". . . 690

Hemorrhage into the Medulla and Pons 691

Diseases of the Brain 692

External Pachymeningitis 692

Internal Pachymeningitis 692

Acute Leptomeningitis 693

Chronic Leptomeningitis 694

Cerebral Hemorrhage 695

Thrombosis and Embolism 699

Cerebral Aneurysms 701

Abscess of the Brain 702

Encephalitis 703

Hydrocephalus , 704

Tumors of the Brain 705

Cerebral Palsies of Children 709

Birth Palsy . 709

Infantile Hemiplegia . . .' 710

General and Functional Diseases of the Nervous System . 711

Epilepsy 711

Jacksonian Epilepsy 715

Infantile Convulsions 715

Chorea 716

Choreiform Affections 718

Spasmodic Tics 718

Hereditary Chorea, or Huntingdon's Chorea 719

Migraine 720

Paralysis Agitans 721

Facial Hemiatrophy - 722

Acute Circumscribed Edema 723

Raynaud's Disease 724

Erythromelalgia 725

Meniere's Disease 726

Occupation Neurosis 727

Hysteria 728

Neurasthenia 733

Part Ix.— Diseases Of The Muscles. Page

Myositis V 736

Acute Polymyositis 736

Myositis Ossificans 737

Myotonia Congenita 737

Idiopathic Muscular Atrophy and Hypertrophy 738

Pseudohypertrophic Muscular Paralysis 739

Juvenile Form of Progressive Muscular Atrophy 740

Facioscapulohumeral Form 740