David Schwimmer

Algae and Medicine

This discussion will be concentrated almost exclusively on the toxic effects of microscopic algae, i.e., phytoplankton. Table I (1) shows a simplified diagramatic scheme of the interrelationship of algae and plankton. The form our contribution will take is not that of a report of an original laboratory study. Rather it will be a digestion and distillation of what has gone before, as seen from a medical perspective.

Management of the myxedematous patient with symptoms of cardiovascular disease

Abstract 1. 1. In myxedema, variations in blood proteins are of no value in following the results of therapy. 2. 2. In myxedema with cardiac failure, variations in the weight of the patient, his basal metabolic rate, and his circulation time are of no value in ascertaining his thyroid status at any particular moment. 3. 3. When taken in conjunction with the initial level, i.e., before treatment, the total blood cholesterol has been a very reliable method of ascertaining the degree of thyroid sufficiency in myxedema with cardiac failure, for it is uninfluenced by the latter in the absence of signs of liver damage. 4. 4. An increase in capillary permeability is a constant feature of myxedema. A decrease from the initially high permeability is one of the earliest and most constant signs of improvement. 5. 5. Thyroid therapy must be used cautiously in myxedema with cardiac failure. The dose should be sufficiently small to avoid an aggravation of the cardiac phenomena, but, no matter how severe the failure is, some hormone should be used. An effort should be made to make the initial dose sufficiently large to effect a decrease in capillary permeability. 6. 6. Satisfactory initial daily doses of thyroid hormone, as desiccated thyroid substance, have ranged from 0.05 to 1 grain. In thirteen cases, stabilization was attained through the daily use of amounts varying from 0.5 to 3 grains.

A fasting-blood-sample procedure in the differential diagnosis and management of hepatic disease

1. A single-venous-blood-specimen procedure (the “composite-test”) for the appraisal of liver function is described. Simultaneous determinations have been made of the icteric index, Van den Bergh reaction, the cephalin-cholesterol flocculation, phosphatase, total cholesterol, cholesterol esters, total proteins, albumin, and globulin. Modifications in standard procedures for the performing of these tests were made whenever necessary in the interests of economy and simplicity, whenever and wherever accuracy was not sacrificed; in some instances, errors were reduced or eliminated. 2. Results of the “composite-test” in 750 patients, performed more than 1400 times, are detailed. 3. Conditions in which the test were carried out have been grouped into intra-hepatic processes, comprising 47.3 per cent of the total; extra-hepatic obstructions, 12.7 per cent; hemolytic processes, 6.1 per cent; and miscellaneous diseases, 33.9 per cent. Diagnoses were confirmed by clinical findings and course, roentgen-ray examinations, peritoneoscopy, biopsy, operation, and autopsy. 4. The data obtained from each individual test have been separately summarized and analyzed in relation to the existing disease state. 5. As a result of serial examinations, a pattern of results to be expected in each of the following syndromes involving hepatic dysfunction has been reconstructed : hepato-cellular jaundice; obstructive jaundice due to calculus; obstructive jaundice due to neoplasm; cirrhosis and fatty degeneration of the liver; hemolytic processes; chronic passive congestion; gall-bladder disease without jaundice. 6. The “composite-test” appears to yield results which are as delicate, as accurate, and as informative as those deriving from the use of the more elaborate individual tests. Comparisons are made with the results of other tests.

THE COMBINATION OF HYPERTHYROIDISM AND PERNICIOUS ANEMIA: REPORT OF A CASE WITH A REVIEW OF THE LITERATURE

Excerpt In the earlier literature on hyperthyroidism, anemia was regarded as one of the characteristic findings. From the reports, it is apparent that the diagnosis was usually made from the color ...

AUREOMYCIN TREATMENT OF RECURRENT CHOLANGITIS WITH LIVER ABSCESSES DUE TO BACTEROIDES FUNDULIFORMIS

Excerpt The purpose of this report is to present an unusual case in which aureomycin was effective against an infection withBacteroides funduliformiswhere other antibiotics failed. This patient is ...

A clinical and therapeutic evaluation of portal cirrhosis.

(1) A study of 246 cases of portal cirrhosis was made. (2) The recognition of the latent and early phase of the disease was stressed. (3) The early symptoms of cirrhosis are vague and may be exclusively referred to the G. I. tract, hemopoietic system, biliary tract, and to the nervous system. (4) A comparative evaluation of the effects of a highly nutritious diet with vitamin concentrates in a group of 112 patients was made with the results in 134 treated by diuretics, paracentesis and general supportive treatment. (5) The best results were obtained in the non-ascitic group and in patients with the early phase of the disease where multiple liver function tests have shown minimal impairment.