Julius Friedenwald

The Clinical Significance of So-Called Chronic Appendicitis

Excerpt Many conflicting views concerning the significance of chronic appendicitis have been held during the past 10 to 15 years. While some clinicians have attributed many disturbances occurring i...

The Roentgenologic Significance of the Filling of the Ampulla of Vater1

DIVERTICULA of the duodenum which have been recorded with increasing frequency in recent years, are now by no means an unusual finding in the routine roentgen-ray gastro-intestinal examination. To the clinician and roentgenologist, they are of considerable interest, due especially to their relation to the ampulla of Vater. The most frequent forms of duodenal diverticula are the congenital types occurring usually in the second portion, though they may appear in other parts of the duodenum. The most common type of congenital diverticulum is usually observed in the region of the ampulla of Vater, ordinarily within a radius of 1 cm. of the ampulla. A shallow depression at the ampulla is not an uncommon finding, and, when the diverticulum is in this form, the roentgen ray reveals a bulge, which may simulate a filled ampulla. This was observed in one instance by us in the human cadaver. Nagal (1) cites a case which at autopsy presented a similar depression into which a true diverticulum opened. Bassett (2) like...

Experimental Studies in Cholecystography

THE advent of cholecystography has unquestionably established one of the most valuable contributions to the sum of our diagnostic methods in the study of gall-bladder disease. This method of examination has assumed such importance that it has already stimulated many workers to further investigations into the numerous problems related to gall-bladder pathology. It was soon recognized that the intravenous method of administration of the dye tetraiodophenolphthalein, as described by Graham and Cole, was not entirely satisfactory as a routine procedure. Due to the toxicity of the drug and the rigid technic required, many clinicians have discarded this method, preferring instead the oral route. Yet even this latter method has not been found entirely satisfactory, for, up to the present time, it has not been thoroughly standardized, due to the fact that the effect of the HCl of the gastric secretion on the dye and consequently on the amount that is absorbed in order to bring about visualization of the gall blad...

The Incidence of Peptic Ulcer Associated with Duodenal Stasis

MUCH interest has been manifested in recent years concerning various affections of the duodenum. Among these, chronic duodenal stasis plays a significant role. In our study of this condition (1), the frequent occurrence of ulceration associated with duodenal stasis has been brought to our attention. In 24 of our cases, reported in 1929, peptic ulcers occurred in three (12.5 per cent). In a review of the literature numerous instances of this association are recorded. As far back as 1909, Codman (2) suggested that chronic obstruction of the duodenum may predispose to the formation of ulcer by causing stasis and the consequent infection of the duodenal contents, and by the forcing back of irritating pancreatic secretions into the pyloric region. Kellogg (3) likewise notes that ulcerations of the stomach and duodenum are observed in a considerable percentage of cases of duodenal stasis and obstruction in which operation has been performed. In 41 instances observed by Kellogg and Kellogg, ulceration was noted ...

Some observations upon the reciprocal relationship between gastro-intestinal and female pelvic disturbances

1. An intimate relationship exists between disturbances of the digestive and female generative organs.