leukoderma colli of syphilis. This conception is like¬ wise entirely apart from the distinction made by the French authors concerning differences between leuko¬ derma and vitíligo. To them, if no hyperpigmented border is present, the condition should be called leuko¬ derma; but if a zone of hyperpigmentation surrounds the area of displaced pigment, the condition should be designated as vitíligo.On the other hand, the conception of leukoderma colli as clinically essentially different by reason of infil¬ tration, accompanied eruption, consistency and struc¬ ture of the skin has not been maintained.From time to time, both here and abroad, statistical papers have appeared giving the numerical percentages of co-appearance of clinical pigmentary dystrophies of the skin and serologie or historic syphilis, or even clinical syphilis. These are interesting and may be consulted.I have never subscribed, however, to the contention that syphilitic patients are more prone than other per¬ sons to present vitíligo or ordinary leukoderma. It is Fig. 2.-Melanoleukoderma colli: lesions extending to the .shoulders in male patient; the mottling is best seen on the dark patch.far fetched, in my opinion, to designate syphilis as.the etiologic factor in every patient with areas of depigmented skin. From the mass of cases, however, the leukomelanoderma or leukoderma colli, or so-called collar of Venus, stands apart as evidently associated with syphilis, and diagnostic of a syphilitic infection. The history of patients with leukoderma colli differs in no material respect from the history of patients of like age and sex who do not present the manifestation. I have not satisfied myself as to any possible associated etiologic condition either physiologic or pathologic. For the present, I will content myself with this ram¬ bling review of the present state of ignorance of con¬ ditions encountered in syphilitic patients.In passing, I will mention briefly the conditions that may require clinical differentiation from leukoderma colli :Chloasma, which is ordinarily found on the face, is infrequently the site of this type of pigmentary syphilid, and the mottling which is part of the characteristic picture of syphilid is absent. Chloasma is present in the older rather than the younger woman, who most frequently presents the melanoleukoderma of syphilis.Tinea versicolor, or pityriasis versicolor, is a scaly disease, as its name reveals, sometimes pruritic, and the organism described by Eichstedt (Microsporon furfur) may be demonstrated under the microscope.Vitíligo and leukoderma of nonsyphilitic patients is usually not symmetrical, and does not present the inter¬ mingling of the café au lait coloration. The question of the presence of vitíligo and leukoderma in syphilitic patients has been mentioned in the body of this paper.1The majority of authors who have written on the subject of diabetes mellitus agree that, in those cases in which diabetes is coexistent with syphilis, antisyphilitic treatment yields but little improvement of the diabetic condi...
After removing the remainder of the organs, the aorta and the heart were removed together, and the aorta was opened along its posterior border (Fig. 1). The diameter of the aorta was increased from its origin to the level of the inferior mesenteric artery, and this was most marked in the ascending portion. There were atheromatous plaques throughout the intimal surface most prominent in the abdominal aorta, with some calcification but no ulceration. From the level of the inferior mesenteric artery to a distance 2 cm. below the left subclavian artery, there was a double-barrelled aorta. The abnormal channel in the wall of the aorta involved up to 2/3 of the circumference, and lay posteriorly and laterally, the anterior portion being spared. The Canad. M. A. J.
Those of us whose privilege it was to serve our country during the first world war and to observe in the past few years the gradual destruction of principles for which we fought now face a new world conflict. Those of us who have an opportunity now to participate in the defense of our nation must turn our attention to a study of medical needs during the present emergency and to planning for the postwar world. Such planning should consider the rehabilitation of mankind and the establishment of a permanent peace which will assure to every man, woman and child freedom of thought, freedom of action and liberty. Hate, despotism and tyranny should have no place in a postwar world dedicated to humanity. Medicine has a fundamental role and will assume an integral part in the establishment of enduring world peace. Without healthy minds and bodies, no nation of civilized men can survive or prosper.The government of the United States was founded on certain principles which establish our present mode of living, thinking and acting. These principles were writ¬ ten into our Constitution by Thomas Jefferson, the anniversary of whose two hundredth birthday we recently celebrated. The dedication of a memorial to him, in the city of Washington, pays tribute to a great man who wrote "We hold these truths to be self evident : that all men are created equal, that they are endowed by their Creator with certain unalienable rights ; among these are life, liberty and the pursuit of happiness." He also gave expression to a guiding principle, on which a sound program of medical planning is based, when he said "I have sworn upon the altar of God eternal hos¬ tility against every form of tyranny over the mind of man." The achievements of the medical profession in our country are an example of the wisdom of such freedom. By scientific progress in the control of infec¬ tious diseases, including the almost complete eradication of a few diseases by prophylactic inoculations, preven¬ tion of accidents, establishment of adequate public health measures and development of better curative treatments, many years have been added to the span of life.The present global war, with its far flung battle fronts, has created many new and unexpected problems and has placed heavy demands on the medical resources of our country. As the war progresses in duration and in intensity, these demands will be greatly multiplied. We must be prepared to meet medical problems as they arise, to supply the immediate needs and to formulate plans for effective service under changing conditions. In formulating such plans the American Medical Asso¬ ciation is not an isolated unit. For the greatest good, the combined and cooperative efforts of ail organizations interested in medical care must be enlisted as partici¬ pants in the program. The in the perfection of plans which will furnish better and more evenly distributed medical ser¬ vice for our people. I know of no time in the history of American medicine when such an undertaking could be more effectively or usefully initiated t...
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