Pub Date : 1933-04-01DOI: 10.1001/ARCHINTE.1933.00150230086003
H. M. Thomas
Hypertrophic pulmonary osteo-arthropathy, as the syndrome is commonly designated in this country, has recently been observed under circumstances different from any heretofore described. A patient whose history I shall give in some detail returned to the clinic following an operation of subtotal thyroidectomy, presenting most exaggerated clubbed fingers and swelling of the lower part of the legs. Roentgenographic studies of the bones revealed a remarkable picture of subperiosteal new bone formation, involving most of the long bones of the skeleton, but showing a change in the bones of the hands which had not been seen by the clinicians or the roentgenologists at the Johns Hopkins Hospital. Since finding in an article by Holthusen 1 the print of an x-ray picture of a hand showing similar changes, I have come across quite a number of articles, particularly in the German literature, which discuss this condition at great length. The cause of
{"title":"Acropachy, or Secondary Subperiosteal New-Bone Formation.","authors":"H. M. Thomas","doi":"10.1001/ARCHINTE.1933.00150230086003","DOIUrl":"https://doi.org/10.1001/ARCHINTE.1933.00150230086003","url":null,"abstract":"Hypertrophic pulmonary osteo-arthropathy, as the syndrome is commonly designated in this country, has recently been observed under circumstances different from any heretofore described. A patient whose history I shall give in some detail returned to the clinic following an operation of subtotal thyroidectomy, presenting most exaggerated clubbed fingers and swelling of the lower part of the legs. Roentgenographic studies of the bones revealed a remarkable picture of subperiosteal new bone formation, involving most of the long bones of the skeleton, but showing a change in the bones of the hands which had not been seen by the clinicians or the roentgenologists at the Johns Hopkins Hospital. Since finding in an article by Holthusen 1 the print of an x-ray picture of a hand showing similar changes, I have come across quite a number of articles, particularly in the German literature, which discuss this condition at great length. The cause of","PeriodicalId":23190,"journal":{"name":"Transactions of the American Climatological and Clinical Association. American Climatological and Clinical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1933-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77272078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1933-01-12DOI: 10.1056/NEJM193301122080204
M. Fremont-Smith
Every physician recognizes the existence of symptoms produced by emotional strain. The significance of these symptoms, however, is very differently interpreted by psychiatrist, internist and physiologist. To the psychiatrist, functional symptoms represent an escape mechanism through which the patient finds justification for past failure or reason for withdrawal from future situations which hold for him an element of danger. For the psychiatrist the little boy's stomach-ache in the early school-morning represents a mechanism, unconsciously produced, which if successful eliminates the necessity of school for that day. Its purpose accomplished, the symptom disappears. From this point of view every emotionally produced symptom is an excuse. Although for secondary reasons the type of symptom presented would interest the psychiatrist, his essential emphasis would be laid on the possible advantage to the patient resulting from the symptom. Until recently the physician has in his turn overemphasized the "organic" one might say the "anatomic" aspect of the picture. He has divided his cases into compartments according to the organ chiefly affected, labeling some "nervous stomach," others "nervous heart," etc. Although he has taken some interest in the physiology, and has studied his cases by X-ray, gastric analysis or electrocardiogram, gross defects disproven, his interest has often waned both in the organ under investigation, and, too often, in the patient himself. "There is nothing wrong," he has said; "go away and forget it" (parenthetically he has added "in any case, go away!"). For the past twenty years a few physiologists have been asking themselves whether anything happens to the organs of the body in the presence of emotional tension and have brought evidence to prove
{"title":"Relationships Between Emotional States and Organic Disease.","authors":"M. Fremont-Smith","doi":"10.1056/NEJM193301122080204","DOIUrl":"https://doi.org/10.1056/NEJM193301122080204","url":null,"abstract":"Every physician recognizes the existence of symptoms produced by emotional strain. The significance of these symptoms, however, is very differently interpreted by psychiatrist, internist and physiologist. To the psychiatrist, functional symptoms represent an escape mechanism through which the patient finds justification for past failure or reason for withdrawal from future situations which hold for him an element of danger. For the psychiatrist the little boy's stomach-ache in the early school-morning represents a mechanism, unconsciously produced, which if successful eliminates the necessity of school for that day. Its purpose accomplished, the symptom disappears. From this point of view every emotionally produced symptom is an excuse. Although for secondary reasons the type of symptom presented would interest the psychiatrist, his essential emphasis would be laid on the possible advantage to the patient resulting from the symptom. Until recently the physician has in his turn overemphasized the \"organic\" one might say the \"anatomic\" aspect of the picture. He has divided his cases into compartments according to the organ chiefly affected, labeling some \"nervous stomach,\" others \"nervous heart,\" etc. Although he has taken some interest in the physiology, and has studied his cases by X-ray, gastric analysis or electrocardiogram, gross defects disproven, his interest has often waned both in the organ under investigation, and, too often, in the patient himself. \"There is nothing wrong,\" he has said; \"go away and forget it\" (parenthetically he has added \"in any case, go away!\"). For the past twenty years a few physiologists have been asking themselves whether anything happens to the organs of the body in the presence of emotional tension and have brought evidence to prove","PeriodicalId":23190,"journal":{"name":"Transactions of the American Climatological and Clinical Association. American Climatological and Clinical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1933-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87020326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1932-12-03DOI: 10.1001/JAMA.1932.02740750008003
G. Minot
Pernicious anemia has been demonstrated by Castle and his associates 1 to be a disorder which they have considered a "conditioned deficiency" disease, to indicate that the deficiency syndrome is the result not of a deficient diet but of a deficient utilization of a normal diet owing to a specific defect in the afflicted individual. They have shown that these patients in relapse lack an "intrinsic factor" secreted by the normal stomach, which when properly brought in contact with an "extrinsic factor," namely, appropriate food, causes material to be formed which is necessary for normal blood production. Like all deficiency disorders, whether due to a lack of a hormone, a vitamin, a mineral or other sustances, treatment must consist in supplying the deficient factor on a quantitative basis. In pernicious anemia the degree of deficiency will vary according to: The degree of deficiency of the intrinsic factor (complete or partial).
{"title":"The Importance of the Treatment of Pernicious Anemia on a Quantitative Basis.","authors":"G. Minot","doi":"10.1001/JAMA.1932.02740750008003","DOIUrl":"https://doi.org/10.1001/JAMA.1932.02740750008003","url":null,"abstract":"Pernicious anemia has been demonstrated by Castle and his associates 1 to be a disorder which they have considered a \"conditioned deficiency\" disease, to indicate that the deficiency syndrome is the result not of a deficient diet but of a deficient utilization of a normal diet owing to a specific defect in the afflicted individual. They have shown that these patients in relapse lack an \"intrinsic factor\" secreted by the normal stomach, which when properly brought in contact with an \"extrinsic factor,\" namely, appropriate food, causes material to be formed which is necessary for normal blood production. Like all deficiency disorders, whether due to a lack of a hormone, a vitamin, a mineral or other sustances, treatment must consist in supplying the deficient factor on a quantitative basis. In pernicious anemia the degree of deficiency will vary according to: The degree of deficiency of the intrinsic factor (complete or partial).","PeriodicalId":23190,"journal":{"name":"Transactions of the American Climatological and Clinical Association. American Climatological and Clinical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1932-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91513892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Importance of the Treatment of Pernicious Anemia on a Quantitative Basis.","authors":"G R Minot","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":23190,"journal":{"name":"Transactions of the American Climatological and Clinical Association. American Climatological and Clinical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1932-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2194434/pdf/tacca200001-0082.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29743849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Osteomalacia-Report of a Case.","authors":"R R Snowden","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":23190,"journal":{"name":"Transactions of the American Climatological and Clinical Association. American Climatological and Clinical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1932-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2194439/pdf/tacca200001-0105.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29743851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Some Little Appreciated Aspects of Malignant Lymphoma.","authors":"H Jackson","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":23190,"journal":{"name":"Transactions of the American Climatological and Clinical Association. American Climatological and Clinical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1932-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2194446/pdf/tacca200001-0177.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29745615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Unroofing of Pulmonary Tuberculous Cavities.","authors":"E H Bruns, J Casper","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":23190,"journal":{"name":"Transactions of the American Climatological and Clinical Association. American Climatological and Clinical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1932-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2194429/pdf/tacca200001-0236.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29745621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Adherent Pericardium and Pick's Syndrome. An Autopsy Study.","authors":"H B Sprague, H A Burch, P D White","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":23190,"journal":{"name":"Transactions of the American Climatological and Clinical Association. American Climatological and Clinical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1932-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2194444/pdf/tacca200001-0311.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29745626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Dextrocardia: A Report of Six Cases, Four Presenting Pulmonary Complications, Two of Which Present Marked Bronchiectasis.","authors":"J J Lloyd","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":23190,"journal":{"name":"Transactions of the American Climatological and Clinical Association. American Climatological and Clinical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1932-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2194447/pdf/tacca200001-0189.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29745616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Accessory Lobes of the Human Lungs.","authors":"W B Soper","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":23190,"journal":{"name":"Transactions of the American Climatological and Clinical Association. American Climatological and Clinical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1932-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2194448/pdf/tacca200001-0211.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29745618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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