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blood is suggestive of carcinoma but does not prove it. The
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the latter and to obtain an even, moist surface. To accomplish this the
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impulse. The fremitus and systolic shock are pathognomonic, and may
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to their number, time of eruption and structure may not be amiss.
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but it occurs rarely, and Bard has described its ravages in California.
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Differential Diagnosis. — When the murmur of mitral stenosis is very
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of symptoms are present in typical cases — first, those due to involve-
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in the bladder gases may form {pneumaturia). Impotence is a not in-
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intermission of days, weeks, or months may transpire. The attacks
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the pain by exciting the production of gas. A change of air has im-
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exhibits atypical characters : it may be brief and low-toned, and may
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acid. The pulse-tension is increased. These evidences shoA\" a simi-
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early, since this chamber cannot take on much hypertrophy OAving to
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selves in the flushing or blanching of the afi'ected part and in increased
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systems of various animals by various modes, entering the circulation,
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my patients have left the hospital apparently cured and have ex-
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should, however, always excite a strong suspicion of rupture, and in
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efiused into the serous membranes, accompanied sometimes by inflamma-
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cirrhosis, carcinoma or sarcoma, and chronic inflammation.
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Although most common in Bright's disease, uremia may arise also in
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corresponds to the level of the cord involved. This "boundary re-
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greatest enlargement of this organ have been those due to leukemia, the
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Treatment. — The chief indications for treatment are — (1) The arrest
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balsam is then smeared over the site of puncture, and the abdominal
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another step is taken. The period of delay is now much shorter, and
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left of, though near, the sternum. The lateral border-lines of dulness
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{d) Locality. — The cases have appeared in groups, in both rural and
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Modern Surgery. General and Operative. By Johx Chalmers
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6. Fatty cirrhosis results from the abuse of malt liquors in some
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Profound prostration as early as third Profound prostration not earlier than
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and are then ingested by man. The larvae are found in the liver, lungs,