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Some of his observations with regard to genito-urinary surgery are quite as interesting. He even treated congenital anomalies. He suggests cutting of the meatus when narrowed, dilatation of strictures with lead sounds, and even suggests plans of operations to improve the condition in hypospadias.
Chapman mentions a case in which the liver was displaced by dilatation of the sigmoid flexure. Hirsohsprung, Genersich, Faralli, Walker, and Griffiths all record similar instances, and in all these cases the clinical features were obstinate constipation and marked meteorismus. Imperforate Anus. Cases in which the anus is imperforate or the rectum ends in a blind pouch are occasionally seen.
The recent investigations of Stengel and Stanton tend to show that the increase of the heart's work during pregnancy is less considerable than has generally been supposed, and that beyond some enlargement and dilatation of the right ventricle there is not usually any hypertrophy of the heart. The total quantity of blood is raised.
"Where this fluid was produced in abundance by great dilatation that is, in the outer and highly disintegrated strata, the superior specific gravity of the crystals forced it to ooze upward, and thus a great quantity of aqueous vapor was produced on the surface of the globe.
Acute dilatation is not an infrequent cause of death during ordinary labor, and is more apt to occur in these cardiac patients. Septic infections after parturition are prone to cause endocarditis and myocarditis, and a malignant endocarditis may develop from uterine infection or uterine putridity.
The clinical facts for such a supposition are those in which the occurrence of an emotion is followed by flushing of the face, acceleration of the pulse, hot or cold perspirations, phenomena all indicative of dilatation of the blood-vessels, with temporary paralysis of their nerves and of their vaso-motor centre.
There was at the start pain, slight dilatation of the pupil, and slight general hyperemia of the globe. The tension of the eyeball rose to 60 mm., that of the fellow eye being 20 mm. Under miotics the tension fell at first but slightly. It was 55 mm. at the end of a week; but after two weeks came down to normal, 20 mm.
The globe did not suffer any alteration beyond the successive changes of dilatation and compression, which enabled us to mount and descend at will. The thermometer was, during more than an hour, between ten and twelve degrees above zero; this being to some extent accounted for by the fact that the interior of the car was warmed by the rays of the sun.
Burton and Green observed a dilatation of the stellar image into a nebulous patch by the transmission of its rays through a nuclear jet of the comet. Am. Cf. Perrine's negative results for Swift's comet in 1899, Astr. Astr. Pac. Not., vol. xlii., p. 14; Am. The transit had been foreseen by Mr. Ges., Jahrg. xxiv., p. 308; Bull. Cf. Not., vols. xxv., xxvi., xxviii. Cf. Astr. Pac. Astr. Pac.
Should the rise of tension occur, and I have seen it myself, it is doubtless due to the fact that this drug dilates the pupil, which would be especially dangerous if the dilatation should occur before contraction of the ciliary vessels; also the narrowing of the ciliary veins by the adrenalin might by virtue of this narrowing obstruct the gate of outflow.
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