Samuel Hyman

Infectious hepatitis (homologous serum type) in drug addicts.

Summary Twenty-three patients with infectious hepatitis (homologous serum type) which occurred among heroin addicts, predominantly of school age, are reported. Epidemiological evidence indicated that the disease was contracted and spread among this group by means of contaminated syringes and needles. The medical, public health and socio-economic problems associated with this disease among narcotic addicts are stressed.

The Enigma of Tuberculous Peritonitis

Summary Twenty-three patients with puzzling systemic and abdominal complaints were diagnosed as having tuberculous peritonitis: 20 by means of peritoneoscopy and 3 by laparotomy. Of the 23 patients, only 7 were correctly diagnosed clinically before the definitive procedures. Our observations suggest that in a 20- to 50-year old Negro patient with abdominal swelling or pain, or both, with associated symptoms of systemic infection such as fever, wasting, and night sweats, and signs of ascites or gaseous distention and abdominal tenderness, tuberculous peritonitis must be considered in the differential diagnosis. The clinical impression can be supported by finding tuberculosis elsewhere in the body and by the characteristic ascitic fluid containing over 3.5 gm. of protein per 100 ml. The definitive diagnosis, however, can be made by visualization of the peritoneal cavity, by peritoneoscopy or laparotomy, and by obtaining material for histologic and bacteriologic examinations. Prompt antituberculous therapy may be lifesaving.

Gallbladder disease in men: Need for earlier diagnosis and treatment

1. Gallbladder disease constitutes an important problem among men, especially in the age group of 40 and over. 2. Gallbladder disease is as serious and severe a disease among men as among women. 3. Gallbladder disease in men often is either not diagnosed or misdiagnosed as some other gastro-intestinal disturbance, mainly because it is not adequately considered in the differential diagnosis of abdominal symptoms. 4. Earlier recognition of gallbladder disease in men should result in earlier treatment with a subsequent reduction in complications and mortality.

Self-Poisoning and Accidental Poisoning

A series of 468 cases of self-poisoning in teen-agers and adults and a series of 1,645 cases of poisoning in children are reviewed. Special attention is given to detection and therapy of salicylate poisoning, to the serious problem of lead poisoning in slum areas, and to the use of the chelating agent desferrioxamine in treatment of iron poisoning.

Perforation of the gall bladder

1. The incidence of perforated gall bladders is higher than usually assumed, varying from 13–25 per cent of acute gall bladder conditions.

Recognition of the Acute Abdomen

The house officer in the hospital emergency department must be able to recognize many acute abdominal conditions that require immediate operation if morbidity and mortality are to be avoided. This paper is an attempt to outline those diseases most commonly associated with acute abdominal illness and to aid in recognizing and differentiating the variety of puzzling signs and symptoms.