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

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XXIV THE CHARLOTTE MEDICAL JOURNAL constantly to the head and the bowel irriga- She was placed on a liquid diet with dessert- i tions of ice water were continued at inter- spoonful doses of an acid pepsin mixture i vals of every three hours. every three hours. The usual cleansing- The following day the temperature lay bath was also given. Her temperature rose • between 101 and 103 degrees and the pulse steadily from the hour of admission, and at ] at 112. The cold spongings did not seem ') o'clock that evening registered 10,3 de- i to agree with the patient, and external ap- grees, with a pulse of 92. She was given a i plications were confined to the use of the cold sponge bath, and within a half-houi ; ] ; , ice cap and the hot cleansing bath. There the temperature had fallen to 101 .2 degrees. « seemed little gain beyond the status quo Tlie treatment and conditions remained i ante, although there was a slight lessening praclically unchanged until the morning ol of the daily temperature average. There January 31, the patient showing a tempera ; was no amelioration of the subjective symp- ture curve of from 99to 101.5 degrees. The ! toms. rose spots appeared on the abdomen, and i On January 30th an examination of the the positive Widal reaction confirmed the I case record showed that the cyanosis of the diagnosis of typhoid fever. The patien i fingers apparently had no relation to drug began to show emaciation and the charac medication, since it had appeared with regu- terislic sores appeared, necessitating daih ; i I i \ i larity after each cleansing bath, even when cleansing of the mouth. On the mornin' the temperature of these was sufficiently of the 31st the ice cap was ordered to th( ! high apparently to exclude the slightest head, and albumen water added to the diet danger of unfavorable reaction. The gen- The course of the disease showed but littk eral condition of the patient did not seem interruption, the pulse remaining betweer satisfactory, and A-S-phen was again order- 80 and 88, and the temperature showing i ed in five-grain doses every two hours. From somewhat lower curve, between 99.2 anc the time of its resumption the improvement 101.3 degrees. On February 4, atnoon, the " ! in temperature and respiration became mark- temperature was 100.3, pulse 80, respira ed and the patient's general condition im- tions 20. Bacteriologic examination showec i proved, although the pulse continued rapid, the typhoid bacillus present in the urine ir still registering 100 and over. The patient large numbers. The treatment was changec j : i ! i i i j slept better, and took and retained nourish- to A-S-phen in five-grain doses every twc ment more satisfactorily. There was less hours, huprovement in general aopearanct complaint of subjective symptoms. Within was almost immediate, the temperature fol i one week, on Felaruary 6, the temperature lowing the change in medication, only onci , was nearly normal. A week later a dis- rising over 100 degrees, when a cleansinf tinct rise of temperature was noticed, sev- bath was given. It remained normal will I eral times reaching 103 degrees. This, how- a slight recorded rise late in the day to 99 ever, was attributable to a large abscess and once 99.4. Upon February 11, oiif which had begun to form upon the back, week after the inauguration of the treat and to a local vaginal condition, shown by ment by A-S-phen, the temperature remain a greenish-yellow fetid discharge. These ed normal the entire day and thereafteri conditions existed nearly ten days, but with The bacteriologic report showed practical i their improvement under appropriate treat- elimination of the typhoid bacillus from thil ment, the untoward symptoms vanished, urine. The patient was pronounced cure( During this period heroin in doses of one- and was discharged from the hospital oi twenty-fourth grain was given every four February 12. hours. After the evacuation of the abscess Case IV.— Helen K— , aged on February 22, a domes 2?-> the temperature never ex- tic, was admitted to Roosevelt Hospital oi ceeded 100 degrees, and remained usually January 21 with a temperature of 102.1, in at 99. Conditions practically normal as creasing within the hour to 103, pulse 88| regards temperature and respiration were respirations .52. Her skin was very dry aiiii established February 28, but the pulse con- burning, tongue coated, and she complain| tinued at about 100. By March 4 the pulse ed of headache and general malaise, Sh! ;' also began to dryp, registering at that time was given a cleansing bath, followed by 88. On March 9 a moderately full diet was sponging with iced water. The routinl allowed, and from this time until March IS, pepsin-hydrochloric acid mixture was ordei| when the patient was discharged as cured, ed in dessert-spoonful doses every thre progress was rapid and uninterrupted. hours, and she was placed on a milk diet IS a domes- The next morning the characteristic ros| Case III.—Anna S— , aged tic, was admitted to the hospital on Mon- spots were observed on the lower part of th; day, January 18, 1909, complaining of gen- chest, and a positive Widal reaction com eral malaise, and exhibiting hebetude with pleted the diagnosis of typhoid fever. Th a low form of nervousnessr Ilerpulse count day after admission her temperature rose tj was 72, temperature 98.3, respirations 21. 103.4 degrees, pulse 96, respirations 24. 0; : !
ADVERTISEMENTS. Bt-a—ygr-n^TT^fl 7a>^^^î;^«8tS!ila:ssIisa^ 3fllumnf#^ ALT WITH REPRESENTS THE MOST VALUABLE COMBINAvTION ^ OFTONIC AND RESTORATIVE KNOWN TO MEDICINE EISNEFL- MENDELSON CQ.> New York Dr. F T. Meriwether's Private Hospital 24 Grove Street AsHeville, N. C. For Surgical and Gynecological Cases .ludcrn in respects Trained Nl 1 Asheville's superb climate; centrally located, but on a quiet and retired street.
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NORTH CAROLINA HISTORY OF HEALTH DI
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lARLOTTK MEDICAL lOURNAL. ^ SANMETT
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THE CHARLOTTE MEDICAL JOURNAL. Chat
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THE BABIES «HC thrive the best dur
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VIII THE CHARLOIVTE MEDICAL JOURNAL
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THK CHARLOTTE MEDICAL JOURNAL. MILK
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THE CHARLOTTE MEDICAL JOURNAL. NEUR
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PHF. CHARLOTTE MEDICAL JOURNAL. Atl
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AKLOTTE MKDICAL JOl'KNAL E^legant P
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THE CHARLOTTE MEDICAL JOURNAL. "We
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^^ THE CHARLOTTE MfiDICAL JOURNAL.
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' \ fth ORIGINAL COMMUNICATIONS.
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ORIGINAL COMMUNICATIONS, 5 trate ul
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ORIGINIAL COMMUNICATIONS. 7 careful
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; THE CHARLOTTE MEDICAL JOURNAL. 9
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ORIGINAL COMMUNICATIONS. 11 tuber i
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ORIGINAI, COMMCNICATIONS lo neum ab
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The chief causative factors of gast
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ORIGINAL COMMUNICATIONS. to adminis
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ease itself. The deportment of the
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ORIGINAL COMMUNICATIOXS, 21 process
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OEIGINAI. COMMUNICATIONS. 23 down t
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ORIGINAL COMMUNICATIOMS. 25 this In
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ORIGINAL OOMJIUXICATION. 27 tro-int
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ORIGIXAL COMMCNICATIONS. 29 the sam
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ORIGINAL COMMUNICATIONS. 31 tioii.
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EDITORIAL. 33 rUai'lriiio Lnai JOli
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EDITORIAL. oD Ham Jones, of High Po
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EDITORIAL. 37 Siler, of the U. S. A
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8. What is the differential diagnos
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Edgar M. Long, Hamilton. Ben F. Roy
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and H. A. Slack. "Infection and Imm
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EDITORIAI,. 45 Dr. Claude N. Smith
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I C. EDITORIAL. Association, the Am
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REVIEW OF SOUTHERN MEDICAL LITERATU
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REVIEW OF SOUTHERN- MEDICAL LITERAT
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Book Notices. The Popes and Science
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ADBVRTISEMENTS.
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INDEX FOR JULY, Table of Contents f
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ABSTRACTS Genielli, who is himself
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ADVERTISEMENTS. St. Luke's Hospital
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ADVERTISEMENTS. a mixture containin
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ADVERTISEMENTS. SOUTHERN MEDICAL SO
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»»< ADVERTISEMENTS. To obtain the
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— ADVERTISEMENTS. XXIX THE PINES,
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A most powerful non-toxic bacterici
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ADVERTISEMENTS. The Sarah Leigh Hos
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ADVERTISEMENTS. Baby needs Mellin's
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ADVERTISEMENTS. MALT WIXH REPRESENT
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^/^ ADVERTISEMENTS Aseptinol Manufa
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ADVERTISEMENTS. The State Examining
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Much better results will be obtaine
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ADVERTIESMENTS, r^mmmmmmmmmmm^mmm^m
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ADVERTISKEMTS '^he niGKSMITH HOSPIT
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VDVERTISEMEXTS ERUPTION^ Inflammati
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ADVERTISEMENTS. The Success of List
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Jlnnomicemeiit to the medical Profc
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ttiiALIH AFFAiRS LIBRARY Charlotte
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ADVERTISEMENTS. F>OST -TTPHOI RECON
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C ADVERTISEMENTS. BOVININE Reconstr
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ADVERTISEMENTS. Successfully Prescr
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ADVERTISEMENTS ^--«*»iûi4 >Ji^Wo
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\ ADVERTISEMENTS. Significant Requi
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Peak's Supporter ADVERTISEMENTS. Fo
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ADVERTISEMENTS. P0ST=0PERAT1VE CONV
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% ADVERTISEMNTS. PROFESSIONAL CARDS
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ADVERTISEMENTS. THE SPECIJIL FIELD
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IN ADVERTISEMENTS ALBUMINURIA OF BR
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The Charlotte Medical Journal Some
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for typhoid anti-bodies the destruc
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ORIGINIAI. COMMfNICATIONS. h.'l isu
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ORIGINAL COMMUNICATION. 6/ cine. I
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ORIGINAL COMMUNICATIONS. 69 membran
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ORIGINAL COMMUNICATIONS. 71 îve US
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ORIGINAL COMMUNICATIONS subject of
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ORIGINAL COMMUNICATIONS. 75 toxins.
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ORIGINAL COMMUNICATIONS, 77 tions a
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ORIGINAL COMMUNICATIONS. 79 tion or
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ORIGINAI, COMMUNICATIONS. 81 typhoi
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' first I in ' more I I been I youn
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ORIGINAL COMMUNICATIONS.
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ORIGINAL COMMUNICATIONS. .S7 Like m
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ORIGINAL COMMUNICATIONS. 89 as to t
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ORIGINAL COMMUNICATIONS. 91 as we h
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ORIGINAL COMMUNICATIONS. 93 ena sim
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effects of antitoxin treatment and
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EDITORIAL. JamesBarrinalectureon J/
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EDITORIAL. 99 logically what hither
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EDITORIAL. the father did not influ
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EDITORIAL. 103 quently they repeate
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J treatment of alcohol and drug add
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with their wives, daughters and inv
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Countv: Dr. \V. H. Ward, Plymoulli,
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REVIEW OF SOUTHERN -MEDICAL LITERAT
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Book Notices. Treatment of the Dise
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BOOK NOTICES. 119 rations and to th
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ABSTRACTS. 121 , women are subject
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ADBVETISEMENTS. The Girculatorj Dan
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. ABSTRACTS. of the rectus. This op
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INDEX FOR AUGUST. Table of Contents
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m^% ./AMENORRHEA DYSMENORRHEA -": M
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ADVERTISEMENTS. 131 THE CHARLOTTE S
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^tttmai Attest ADVERTISBMRNT3. To o
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ADVERTISHEMTS flp?!lj!uco?ie A most
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ADVERTISEMENTS. St, Luke's Hospital
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' > ' " ' ADVERTISEMENTS. >^^_ ,i&-
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I «43«« ADVERTISEMENTS. MALT IRO
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:': rflflN m WEflKEiT utih- ^ Z^flM
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ADYERTIESMEWTS, Inflammation's Anti
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This is the Food for your baby pati
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VDVERTISEMENTS ERUPTIONS Inflammati
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ADVERTISEMENTS The Success of Liste
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SOUTHERN MEDICAL SOCIETIES. MISSISS
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-'" fî-r/\jRs ÎBR/{}^Y jharlotte
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. // is a fact that ADVERTISEMENTS.
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C ADVERTISEMENTS. BOVININEI Reconst
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ADVERTISEMENTS. ^11 the tfc® Nmtur
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ADVERTISEMENTS Is pre-eminently ser
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ADVERTISEMENTS, Milk prepared with
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f ^ Peak's /^^^*=^=^\ Supporter ADV
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ADVERTISEJIENTS. BUFFALO LITHIA SPR
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ADVERTISEMNTS. I PROF ESSIONAL C AR
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Intestinal ADVERTISEMENTS. ^ '"°'"
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Oar ADVERTISEMENTS THE CHILD THAT F
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The Charlotte Medical Journal Antit
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ORIGINAI, COMMUNICATIONS. 139 tinuo
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ORIGINAL COMMUNICATIONS. 141 tiiict
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ORIGINAL COMMUNICATIONS. 143 by Shu
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ORIGINAL COMMUNICATION. 145 can be
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ORIGINAL COMMUNICATIONS. 147 Americ
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ORIGINAL COMMl'NICATIONS. 149 senti
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The reason for this is that the blo
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ORIGINAL COMMUNICATIONS. 153 chroni
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ORIGINAI, COMMUNICATION. 155 diment
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ORIGINAI. COMMUNICATIONS. 157 maind
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Charlotte Medical Journal EDITORIAL
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' attention, of the ray, and must t
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EDITORIAL. 163 one of the most sign
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165 morbidity from this disease. Ev
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North Carolina Medical College Open
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REVIEW OF SOUTHERN MEDICAL, LITERAT
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REVIEW OF SOUTHERN MEDICAI. LITERAT
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REVIEW OF SOUTHERN MEDICAI, LITERAT
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BOOK NOTICES which he lives, etc.,
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Prognosis In Tetanus.—Patton in T
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ABSTRACTS. 179 amination of every o
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ABSTRACTS. 181 Opium in the Therape
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ABSTRACTS 18,5 pleural pain, and wa
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ABSTRACTS. 185 been removed by lith
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ABSTRACT. 187 a general peritonitis
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Of the patients three were spinster
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ABSTRACTS. 191 —minimal dazzling,
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' ABSTRACTS. • 193 cellulofibrino
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ABSTRACTS. 195 George Lincoln Walto
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AD8VRTISBMBNTS. 197
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ABSTRACTS. juprarenalis. The thyroi
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TABLE OF CONTENTS FOR SEPTEMBER. Ta
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ion ceosed rather abruptly above at
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to heal the sick man as to maintain
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THE ADVERTISEMENTS. CHARLOTTE SANAT
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**< I mi ADVERTISEMENTS. To obtain
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W^mB ADVERTISEEMTS A most powerful
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UNpT. il ADVERTISEMENTS. Aseptinol
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ADVERTISEMENTS. ^^^2ZSi^^ aohannfoj
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If Interested "Êwp FOR Samples h L
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^-MiMi^^ ADVERTIESMENTS, (Inflammat
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A physiologically correct food. A
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VDVERTISEMENTS ERUPTIONvS Inflammat
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SOUTHERN MEDICAL SOCIETIES, MISSISS
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ADVERTISEMENTS. In TREATING BRONCHI
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c ADVERTISEMENTS. BOVmiNE Reconstru
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ADVERTISEMENTS. Does not cause the
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lDVERTISEMENTS Is physiologically a
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ADVERTISEMENTS, IX PANOPEPTON Consi
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^ Peak's \ Supporter ADVERTISEMENTS
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ADVERTISEMENTS. BUFFALO LITHIA SPRI
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—— ADVERTISEMNTS. I PROF ESSION
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Intestinal ADVERTISEMENTS. Dyspepsi
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ADVERTISEMENTS NEURASTHENIC "BREAKD
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The Charlotte Medical Journal Vol.
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ORIGINAL COMMUNICATIONS. 215 a dise
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ORIGINAL COMMUNICATIONS, 217 any of
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ORIGINAL COMMUNICATION. 2l9 accurac
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ORIGINIAL COMMUNICATIONS. 221 of an
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ORIGINAL COMMUNICATIONS. 223 in spi
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ORIGINAL COMMUNICATIONS. 225 i the
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ORIGINAL CO.MMUNICATIONS. 227 branc
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ORIGINAL COMMUNICATIONS. 229 where
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ORIGINAL COMMUNICATIONS. 231 the dr
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1 fraction ORIGINAL COMMUNICATIONS.
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ORIGINAL COMMUNICATIONS. 235 But th
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. ORIGINAL COMMUNICATIONS. ant ones
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ORIGINAL COMMUNICATIONS, 239 aftern
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ORIGINIAL COMMUNICATIONS. 74 J firs
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Charlotte of t^ê Medical problem J
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works, making a total of 21n deaths
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DR. llô^^'OK COOK, DISCOVERER, lie
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EDITORIAL. 249 of a tetanic nature.
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EDITORIAL. T-< ^^:hjS^^' ->^'- - S-
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J I Board i the EDITORIAL. 253 affo
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A Case ol BaclIIary Infection of th
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ABSTRACTS. indicates that a point n
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ABSTRACTS. 261 should be added thos
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ABSTRACTS. 263 sat up ill bed on th
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ABSTRACT. 7^5 sore throat that are
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ACTS 267 The Etiology ot So-Called
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nig of the spongy layer. This occur
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ABSTRACTS 271 1 It should be so adm
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AUBVKTISEMENTS. A considerable prop
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iig, immediate ligature is preferab
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TABLE OF CONTENTS FOR OCTOBER. 277
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ufactuiî, Katherine L. Storms, M.
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ABSTRACTS. Electricity in Ibe Diagn
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ADVERTISEMENTS. THE CHARLOTTE SANAT
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ADVERTISEMRNTS. B-^^'^»^BS fa For
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ADVKRTlSHK.MTS A most powerful non-
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ADVERTISEMENTS. St Luke's Hospital
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ADVERTISEMENTS. Ascftinol Manufactu
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— ADVERTISEMENTS. MALT WITH REPRE
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Ê BRIDGE BETWEEN DI6EA5E and MEALT
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ADVERTIESMENTS, HUMAN HANDS HAVE NO
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ADVERTISEMENTS. You are more assure
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VDVERTISEMENTS The First Applicatio
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SOUTHERN MEDICAL SOCIETIES, MISSISS
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'^"^^*^'^3«»v Iharlotte Medical J
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ADVERTISEMENTS. Id MEET Yhreatening
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ADVERTISEMENTS. i=[>iui;ii;ij wm Re
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ADVERTISEMENTS. Successfully Prescr
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ADVERTISEMENTS ^-Xc^xjui'sJiJ^tenoi
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THE I "I I) ADVERTISEMENTS, s Essen
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TASTELESS ADVERTISEMENTS. WHY Water
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ADVERTISEMENTS. XIII LITHIA SPRINGS
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ADVERTISEMNTS. ? :$:?: - >:?:$: - >
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t^-^-''' ADVERTISKiMENTS. >r,T-ini
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lDVERTISEMENTS THE ILLS Oh THE AGED
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; !;> The Charlotte Medical Journal
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ORIGINAL COMMUNICATIONS. 291 that a
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ORIGINAL CO.MMCNICATIONS. 203 pubii
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ORIGINAL CO^niUNICATIONS. 295 quack
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ORIGINAL COMMUNICATIONS. 297 sand o
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ORIGINAL COMMUNICATIONS. 299 stitut
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a unit work to this end and it will
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ORIGINAL COMMUNICATIONS. nobility.
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ORIGINAL COMMUNICATIONS 30S covered
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ORIGINAL COMMUNICATION. 307 of the
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, ORIGINAL COMMUNICATIONS. 309 u- i
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KDITORIAL. Charlotte Medical Journa
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EDITORIAL. 313 assumption on the ph
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EDITORIAL. 315 definite locations,
Page 513 and 514: EDITORIAL. -,jy '^ """''"' S. C.i D
Page 515 and 516: EDITORIAL. AI
Page 517 and 518: EDITORIAL. 321 EDITORIAL NEWS ITEMS
Page 519 and 520: EDITORIAL. 323 solely of addresses
Page 521 and 522: EDITORIAL. -,,r Soci^r'"'' '' ''" '
Page 523 and 524: ABSTRACTS. 397 the iiKliyidual girl
Page 525 and 526: ABSTRACTS 329 ble nurse—provided
Page 527 and 528: ABSTRACTS. ^'°" '''" ^"^' ""^'^ °
Page 529 and 530: BOOK NOTICES -,.. of Preventive Med
Page 531 and 532: ABSTRACTS. hyj,e,nc pnncples. Where
Page 533 and 534: ABSTRACTS. 337 spinal fluid of epil
Page 535 and 536: ABSTRACTS. -,^q in which, in anv ev
Page 537 and 538: ABSTRACTS. 341 then there has been
Page 539 and 540: ABSTRACTS 343 Antilormln in the Det
Page 541 and 542: I harmless. I peculiarly Calcium Sa
Page 543 and 544: ABSTRACTS. :over chancres on the li
Page 545 and 546: AUEVKTISE.MliNTS. 349 A considerabl
Page 547 and 548: REVIEW OF SOUTHERN MEDICAI, LITERAT
Page 549 and 550: TABLE OF CONTENTS FOR NOVEMI Table
Page 551 and 552: REVIEW OF SOUTHERN MEDICAL LITERATU
Page 553 and 554: REVIEW OF SOUTHERN MEDICAL LITERATU
Page 555 and 556: ABSTRACTS. 359 DOCTOR: OUR RESPIRAZ
Page 557 and 558: ADVERTISEMKNTS. For Upwards of Fort
Page 559 and 560: ADVERTISHEMTS A most powerful non-t
Page 561 and 562: ADVERTISEMENTS. St. Luke's Hospital
Page 563: Balttmore^Md. Pine Ridê Sanitoriii
Page 567 and 568: fflflN ITi WEflKEJT UNK- IT 15 NOT
Page 569 and 570: ADVERTIESMENTS, HUMAN HANDS HAVE NO
Page 571 and 572: ADVERTISEMENTS. after circumcision
Page 573 and 574: VDVERTISEMENTS Instantaneous Is the
Page 575 and 576: ADVERTISEMENTS The Success of Liste
Page 577 and 578: SOUTHERN MEDICAL SOCIETIES. MISSISS
Page 579 and 580: Charlotte Medical Journal. A SOUTHE
Page 581 and 582: ADVERTISEMENTS. lo Meet Ihreateninc
Page 583 and 584: c ADVERTISEMENTS. BOyiNINE Reconstr
Page 585 and 586: ADVKRTISEMENTS. A.II the i« ^mdL®
Page 587 and 588: ADVERTISEMENTS DR. STEEDLY'S PRIVAT
Page 589 and 590: ADVERTISEMENTS, Fairchild's Essence
Page 591 and 592: ADVERTISEMENTS. W LgLtest Scientifi
Page 593 and 594: BUFFALO ADVERTISEMENTS. XIII ALBUMI
Page 595 and 596: ADVERTISEMNTS. I PROF ESSIONAL CARD
Page 597 and 598: OE3 ADVERTISEMENTS. I o n Quihgesim
Page 599 and 600: ADVERTISEMENTS THE ANEMIA OF BRIGHT
Page 601 and 602: j j 1 The Charlotte Medical Journal
Page 603 and 604: ORIGINAI, COMMUNICATIONS 367 diagno
Page 605 and 606: — ORIGINAL COMMUNICATIONS. 369 Dr
Page 607 and 608: ORIGINAL COMMUNICATIONS. !...v.ed I
Page 609 and 610: ORIGINAL COMMUNICATION. 373 Iter in
Page 611 and 612: ORIGINAL COMMUNICATIONS. 375 )f the
Page 613 and 614: ORIGINAL COMMUNICATIONS. 377 no occ
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ORIGINAL COMMUNICATIONS --n Û.: ra
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ORIGINAL COMMUNICATIONS. 381 ffiveh
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ORIGINAL COMMUNICATIONS. 383 i desi
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, ORIGINAL COMMUNICATIONS, ."iS.S o
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ORIGINIAL COMMUNICATIONS. .'iS? is
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EDITORIAL. .389 Charlotte ture prop
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EDITORIAL. 391 ation of information
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EDITORIAL. 393 decrease of urinary
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[ ! his I to DK. RUSSEUU MOVES TO f
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man and Dr. li. Eugene Mitchell, of
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. EDITORIAL. 3^9 J. S. Wynne, Dr. A
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EDITORIAL. 40] . ; . ellagra," Dr.
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BOOK NOTICES 405 . 1 This book is i
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ABSTRACTS. 407 ical Society, contri
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ABSTRACTS 409 Certain Bacillus Coll
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ABSTRACTS. at this Stage to check t
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Bl^tr:i:îê:S':::r^^'^:^: ;J;-Pati
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ABSTRACTS. 415 tastases and recurre
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Clinical ADEVRTISEMENTS. FUNCTIONAL
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ADVERTISEMENTS. 419 ra For Upwards
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Tblosinamlne In Deafness.— Mollis
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p was a notorious one. He not only
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TABLE OF CONTENTS FOR VOLUMI Table
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py, bv Edwin Henry 8cborer, M. !) U
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tZ^ ADVEKTISEMKNTS. A Post Graduate
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fidgetiness, especially at night. T
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I actually I ! tion i dition j I be
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ADVERTISEMENTS. DOCTOR: OUR RESPIRA
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ADVKKTISKHMTS A most powerful non-t
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VDVERTISEMENTS The First Applicatio
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Ir Interested Send for Smpics n LiT
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ADVIiRTIESMENTS, HUMAN HANDS HAVE N
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I 'A ADVERTISEMENTS. For your littl
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m I Sy R E P R E S E NTS THE M O ST
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Vol. 60, 1909 - University of North Carolina at Chapel Hill

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