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Albany medical annals . and spongy. The buccal mucous membrane is violaceous, numerousdilated capillaries are visible. No varices or telangiectases are present. Lungs Increased vocal fremitus and dulness in left supraclavicular and infra-clavicular regions, broncho-vesicular breathing and numerous sub-crepi-tant rales, otherwise the note is vesiculo-tympanitic throughout with pro-longed low pitched expiration. H eart Distinct epigastric pulsation. The apex is not visible or palpable, nofriction or thrills. The cardiac area is entirely effaced by a hyper-resonantnote. No adventitious sounds are
Albany medical annals . and spongy. The buccal mucous membrane is violaceous, numerousdilated capillaries are visible. No varices or telangiectases are present. Lungs Increased vocal fremitus and dulness in left supraclavicular and infra-clavicular regions, broncho-vesicular breathing and numerous sub-crepi-tant rales, otherwise the note is vesiculo-tympanitic throughout with pro-longed low pitched expiration. H eart Distinct epigastric pulsation. The apex is not visible or palpable, nofriction or thrills. The cardiac area is entirely effaced by a hyper-resonantnote. No adventitious sounds are discernible, the pulmonic and aorticsecond sounds are distinctly accentuated. The vessels of the neck are full,but the veins appear to show no abnormal pulsations. The radial andtemporal arteries are of equal volume and size but distinctly thickened;an occasional premature beat occurs accompanied by a long compensatory To Illustrate Dr. Gordiniers Article on Unilateral Medical Annals, February, HERMON C. GORDINIER 53 pause. The x-ray picture shows a moderate increase in size of the wholeheart. Abdomen Is greatly distended, the veins are very prominent; percussion revealstympany in the epigastric and upper half of umbilical region with change-able flatness in the loins; a very distinct fluctuation wave is present;inguinal herniae are present on both sides. No disparity in size seems toexist in regard to the testicles. Liver Owing to the abdominal distention it was not possible to outline accurate-ly the liver dulness. After paracentesis abdominalis and the removal ofeight quarts of fluid, the liver dulness was found to extend from thesixth interspace six centimeters below the costal border. At about theposition for the gall bladder or possibly a little to the left, a mass wasdiscovered which was somewhat irregular in outline and apparently tookits origin from the right lobe close to its (junction with the left. Other-wise the lower border though firm,
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Keywords: ., bookauthorm, bookcentury1900, bookdecade1910, booksubjectmedicine