10.04.2013 Views

Vol. 60, 1909 - University of North Carolina at Chapel Hill

Vol. 60, 1909 - University of North Carolina at Chapel Hill

Vol. 60, 1909 - University of North Carolina at Chapel Hill

SHOW MORE
SHOW LESS

You also want an ePaper? Increase the reach of your titles

YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.

165<br />

morbidity from this disease. Everybody much more than the ordinary milk insnect-<br />

*°"^^<br />

alT;be%,W '^H°\Jr''''P''r"''"'^''"^ "°" P"^*'^^d is needed. Tvery<br />

.11 the time, and th<strong>at</strong> even when a c.ty is dairy which is allowed to supply<br />

exempt milk to<br />

from an<br />

a<br />

epidemic there must be city should be under vigorous<br />

many control<br />

sources The<br />

<strong>of</strong> infection. The Yale Med- individuals engaged in trades like baking!<br />

ca] Journal editorially on this subject cites where food is handled freely,<br />

he<br />

should<br />

recent<br />

also<br />

results <strong>of</strong> studies by Kayser in be under sanitary inspection.<br />

erniany. Thorough<br />

1 his investig<strong>at</strong>or has reported disinfection <strong>of</strong> all articles <strong>of</strong> <strong>at</strong>tire<br />

the results which<br />

o several years' investig<strong>at</strong>ions, have been worn bv typhoid fever p<strong>at</strong>ients<br />

-n the city <strong>of</strong> Strasburg, during which pe- before and during their illness should be dg<br />

ri.M hundreds <strong>of</strong> cases were carefully orously carried out. The necessity for rout-<br />

Hieir infection ine examin<strong>at</strong>ion for bacillus carriers is also<br />

t .red Xn ^'^ tiace when •Ki'"'"„''<br />

1 possible. He found th<strong>at</strong> in apparent, as about five per cent, <strong>of</strong> all tv-<br />

Strasburg nearly one per thousand <strong>of</strong> the phoid p<strong>at</strong>ients become chronic carriers uiiniliabitants<br />

(the total popul<strong>at</strong>ion being der existing circumstances. This means<br />

1 ^' I OOO ) contract typhoid fever each year, several hundred carriers in a city <strong>of</strong> 150 f>f 000<br />

the sources <strong>of</strong> infection raw milk is the All <strong>of</strong> these things go to show th<strong>at</strong><br />

most^enous.<br />

the<br />

Over one quarter <strong>of</strong> the cases stamping out <strong>of</strong> typhoid fever, if it is<br />

could<br />

ever<br />

be traced to tlie use <strong>of</strong> uncooked milk, system<strong>at</strong>ically <strong>at</strong>tacked, will be a<br />

cream,<br />

prolonged<br />

or .sour-milk; less frequently to the and expensive process,<br />

use <strong>of</strong> butter-milk. The mixed milk <strong>of</strong><br />

lar-e dairies was found to be <strong>at</strong> fault as « PftTHOOiNOMOMic sign or appeindiwell<br />

as th<strong>at</strong> <strong>of</strong> small concerns, and it was oiTis.<br />

''"''' '^'^''' classical group<br />

an<br />

<strong>of</strong><br />

tliecitvwier<br />

symptoms do not always<br />

B<strong>at</strong>hin'.<br />

n .m!,nf^^ \ ^^th'"8^ or swimming necessarily arise because <strong>of</strong> appendix dis-<br />

'''' s ns!wr<br />

And<br />

llL<br />

much more is this<br />

w''.""''"^';^^"'."''-" Leo^ the<br />

''"" ^'"'^"'^"^ '^'"'^ '"^^'^ cases in<br />

1 . curredi,Ti'"eTr, which<br />

'"f<br />

the<br />

^f ?, ^''"1'^- p<strong>at</strong>ients go about,<br />

t.e N pursue their Comae vShnt/f<br />

voc<strong>at</strong>ions.<br />

"n f<br />

/-^"l^'; t "••"> P<strong>at</strong>ien s was respon- and <strong>at</strong> times complain <strong>of</strong> pain in the rieht<br />

'"'•"/ '''^''''" ^" half <strong>of</strong> the lower<br />

; I "all Ihes^-'T abdomen-over Mc Bur-<br />

^'•^.^^^-^"•- "e.v's point, in the<br />

. M afii<br />

inguinal .'aland region,<br />

1 had'f^h had or<br />

not<br />

even<br />

been diagnosed ly- about the umbilicus. The first and most<br />

ons ve;e uoiiZ \ yu^ "'"'^ '"" ""P"^'^"' ^"^^t'°" ^'^^ -"f"^^ the X'-<br />

'\l.ttle over nine sician<br />

,e X t nf.l.r<br />

when consulted bv a person <strong>of</strong> this<br />

,<br />

l'^'^.*^^^" '"f-/^'l group, or even<br />

•onacfw when called to a hKn case <strong>of</strong> a<br />

\"^^''en<br />

ercL<br />

»-« acute character, is:<br />

letn<br />

Is<br />

per<br />

this<br />

cent, appendi-<br />

<strong>of</strong>^^H^^^^ ot the p<strong>at</strong>ients no definite citis'<br />

"The studv'<strong>of</strong> ule'""''^ '" l'"''^ , ^ '^'^" ^'^''^^ ^^'^ ^"^^ly be called p<strong>at</strong>ho-<br />

"""'^^"°"'^ "f '^' P*- Knomonic would<br />

...<br />

prove <strong>of</strong> inestimable value<br />

ie c 1 ts shied shoued th<strong>at</strong> certam trades were to the diagnostician. Dr. H. Illowav<strong>of</strong><br />

.^''^^ f-" ^'ew York^ has recently described iTi '^Xr-<br />

uen h. ubie Mo i/'^^,/--^'<br />

^f.^^]ff-rthe chives <strong>of</strong> Diagnosis"<br />

^c^ a sign<br />

owed He it. r' which he be-<br />

lieves to be<br />

lem<br />

p<strong>at</strong>hognomonic. It is Icsf elicited<br />

ha^^^<br />

''"^' f"°^.^^'^^ as follows: ', •S<br />

The p<strong>at</strong>ient is<br />

imr liuTr^ placed <strong>at</strong> full<br />

'^^^^^^<br />

; oemlers '""^^^<br />

and H, ,<br />

/"i"""'' °" =^ ^'' ''''^^'^- He is lounakers then in-<br />

and those handling food or structed to flex the leg upon the thigh uid<br />

re olfsr/hamUed " '"' ^'^^ ^'^''^'^ ^P"" ^^^ '"''"^<br />

T't'- 'T "P°" 'he Ixe u<br />

I,""'<br />

V d • IZf !Z Tf 1 \ '" ""''^ V" '°" °f ''^''"^ '' '^ ascertained whether the<br />

"" seae BlrbL f A<br />

'° '^' movement, or r<strong>at</strong>her the<br />

^V'^<br />

upward pressure,<br />

peculiar -ex- causes<br />

eiTtmn' .n Ir T^^tu^ any pain or soreness to be<br />

^}:':\ ," /"'/"^, The investig<strong>at</strong>ion felt in the right half <strong>of</strong> the abdomen, i. e.<br />

lioL- i't m ^^''"f"'^' * the appendicular region. If<br />

'°"f none or very<br />

°' '"'•'''"<br />

'*'''^ '^ f^'* '^^ -<br />

\se nfrn, 1 f r T ^'"Sh is more forcibly flexed<br />

ise through infection from certain either by the p<strong>at</strong>ient's own effort<br />

or<br />

or by<br />

other<br />

the<br />

sources <strong>of</strong> common food physician. Again it is inquired whether<br />

•<br />

.. ,. , any pain or soreness is felt or whether it is<br />

nirs'tlfevrr'r^<br />

gre<strong>at</strong> value, increased. Next the p<strong>at</strong>ient is directed to<br />

extend the leg to full length with a quick<br />

iI ihuidLl^r^ .<br />

,'l>".cl fever in "'rl°^Pu''^"\'°"<br />

cities. They show th<strong>at</strong> and r<strong>at</strong>her sudden movement, care being

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!