A single case of multiple arthritis will serve to illustrate the obstacles iu the way of making a diagnosis. CASE XV. CARIES OF THE ANKLE; SYMPTOMS OF SPINAL CARIES TWELVE MONTHS AFTER INVASION OF ANKLE DISEASE ; MALARIAL COMPLICATIONS MASKING THE SYMPTOMS OF BONE DISEASE ; SYN-OVITIS OF BOTH KNEES NINE MONTHS LATER. Harold S., aged three, came under treatment as an outpatient , December 3, 1879, with a history of lameness dating from the preceding April. The only one of the exanthemata he had had was pertussis, and this was in June, 1878. He is the third of five chil
PERSONAL experience has led me to believe that dislocation of cervical vertebrae, without fatal re. suits, is by no means of rare occurrence. Besides the eight cases which I published in 1889" and 1890,3 I had seen seven more, and had been communicated with regarding an eighth, making a total of sixteen, up to the publication of an article on the subject in 1892.1 In that publication a method of reduction was suggested which was theoretically correct, as shown by the manipulation of the vertebrae and by experiments upon the cadaver, made by Dr. Richardson and myself.A case has recently occurred in the Massachusetts-General Hospital, in which the practical success of the method was demonstrated upon a patient by Dr. Beach. This case will be reported by him later, so that I refrain from going into the details, but its success justifies me in recalling the subject here.The commonest form of dislocation, without fatal re_ suits, is the unilateral form, in which an articular process slips over the one below, causing the head to cant to one side and to twist so as to produce a similar position to that assumed in torticollis, the diagnostic feature being the immobility of the head in its new position, combined
for suggesting the chart system in place of the more cumbersome plan I had previously adopted, and for arranging the charts for publication. The pen and ink illustrations I have made from fresh specimens and from examples in the Gray Herbarium, through the courtesy of Dr. Goodale.
. The Classic Article is Ó1905 and is reprinted with courtesy from Walton GL, Paul WE. Contribution to the study of spinal surgery: one successful and one unsuccessful operation for removal of tumor.
Kolbe and Frankland'. Having been requested by Prof. v. Meyer to investigate its physiological action, I have found it P powerful poison acting on the central nervous system. I owe Prof. L u d w i g many thanks for his kindness in allowing me the use of his laboratory for this investigation. The following is a short description of the preparation and chemical properties of this substance2: Methylkyanethine is a crystalline base, which fuses at 740 C., and distils undecomposed at about 2580 0. It dissolves quite readily in water, and gives a strongly alkaline reaction; on warming, it is in great part separated from this solution in the form of an oily fluid. Its composition is expressed by the formula C00H17N3 (= C,H,(CN)N3. In the process of preparing it, kyanethine is strongly heated with iodide of methyl. The crystalline product contains iodide of methylkyanethine, from which the free base can be obtained in various ways.
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