File:Interstate medical journal (1906) (14781532984).jpg

Identifier: interstatemedica1319unse (find matches)
Title: Interstate medical journal
Year: 1906 (1900s)
Authors:
Subjects: Medicine
Publisher: St. Louis, : Interstate Medical Journal
Contributing Library: The College of Physicians of Philadelphia Historical Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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is no ulceration or erosion of the gums or mucous membranes, andthe odor is not especially bad; the tongue is thick, dry, cracked and heav-ily coated. He has a highly arched palate. The tonsils, the anteriorpillars of the fauces, the uvula and the soft palate are cedematous. On theposterior wall of the pharynx is seen considerable quantity of yellow 436 MYER. mucous. The mucous membrane of the nose is dry. The nasa-pharvnxcould not be examined. Glandular System.—There are chains of enlarged lymph nodes in theanterior and posterior cervical regions on both sides. These nodes areabout the size of navy beans and do not coalesce. The sub-maxillary andsub-lingual glands are considerably enlarged. These, as well as thelymph nodes, are painful to pressure. There are a few enlarged nodesabout the size of peas, in the left axilla and two in the right axilla. Thelymph nodes in the right and left groin are but slightly enlarged. Asidefrom this, the glandular system is not apparently involved.
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Fig. 1. Heart.—The dullness not. clearly made out on account of an existingemphysema. The apex beat is palpable in the fifth interspace. Theheart-beats are rapid, but regular and strong. The first sound at theapex is impure; no murmurs to be heard. The pulse 120, fairly full andstrong. Lungs.—Over the right lower lobe posteriorly the percussion note issomewhat flat and a few moist rales are heard. Over the upper left lobeanteriorly, prolonged expiration. The lungs are otherwise normal. Liver.—The dullness cannot be made out anteriorly; in all probability PSEUDO-SCORBUTIC TYPE OP ACUTE LYMPHATIC LEUKAEMIA. 437 on account of a loop of intestine lying in front of the liver. The dullnessin the axillary line indicates normal size and position. Spleen.—Is not enlarged and cannot be palpated in any position ofthe patient. Percussion indicates normal size and position. The abdomen is not sensitive to pressure, but slightly tympanitic. Pressure over the shaft of long bones seems to eli

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