The appetite is feeble or nil, the tongue heavily coated, the bowels constipated, and in an advanced state of the disease, the patient is much emaciated. The thoracic symptoms which may result from the local efl'ects of acute peritonitis are hiccough, which is in many instances very distressing; the form of dyspnnea in which shallow, superficial, and upper costal; sometimes cough, although the patient makes every effort to suppress it; and cardiac disturbance, the action of the heart becoming very rapid. It occurs in acute regurgitation and aortic stenosis upon failure of compensation, when it is known as secondary relative insufficiency. These tumors cause local bulging of the chest wall, dulness of irregular outline, effusion into the pleural sac, and compression of the lung, large venous trunks, and the cesophagus, and they may invade the mediastinal spaces. Inflammation is thus started, followed by I exudation, generally of a purulent character, but sometimes serous, and in weakly and, These malformations are described in the article Heart, Congenital Misplacements of. Patients suffering thus may present a peculiarly stunted apjicarance. Of reflex irritation in the teeth, eyes, etc., must be investigated.

They have, moreover, received designations descriptive of their functions or distribution. The operation lasted three-quarters of an hour, and was most successful, thanks to the Trendelenburg canula, to which I superadded an iodoform pad. Pain is an early and important of the sac or internal pressure.

Erectness, firmness, good balance of body and mind, testify to a man, as they do to a racehorse or a gamecock. This gives rise to an internal strabismus, and usually of the eye on the same side as the lesion.

There is slight edema of the lower extremities.

Applied to leaves and other flattened organs.

It is frequent in Holland and in India.

But the condition of the mouth, the absence of severe cachexia, and, as Niemeyer remarks, the comparative ahsence of epistaxis, hiEinatemesis, hiematoma, and bloody evacuations from the bowels in scurvy, will aid at once to settle the diagnosis.

The wall of the heart may be locally or generally involved. While increased chest capacity is, therefore, the great desideratum in preventing and treating consumption, we have https the strongest evidence for believing that it is not so much a question of developing the base of the lungs as it is of expanding the apices. After all amputations we must use sutures of some sort; and how often do we see silk to suppuration, that we are compelled to remove them before there is sufficient union to resist the retraction of the tumefied flaps. The other mistaken notion was the encouragement of too much water. The College of Physicians of Philadelphia has again exercised one of the most important functions for which it was originally established, and which it so recently exercised in connection with the subject of cholera and National Quarantine Regulations. But the observation becomes important in another point of view.

Disorganized or dead part of a limb or organ affected Sphaeraesthesia (sfe-res-the'-ze-ah). Consisting- of sclerosis of the arteries and cardiac hvoertroohy. In summing up the case he reported there were several slow pulse. We "//" had showers of rain during the warm season, but they did not refresh us, as the ground was so hot that as soon as the rain struck the earth it generated a hot steam which would almost suffocate a person obliged to inhale it.


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