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Updated: May 8, 2025
This diminution of energy is evidenced by muscular and mental weakness, by diminished response and by gradual loss of efficiency which finally reaches the state of asthenia. The Muscles. It has been observed clinically that if the muscles are impaired by long disuse, or by a disease such as myasthenia gravis, then the range of production of both heat and motion is below normal.
The disease was first described by Sir William Gull as a cretinoid change, and later by William Ord of London, who suggested the name. It is characterized clinically by a myxedematous condition of the subcutaneous tissues and mental failure, and anatomically by atrophy of the thyroid gland.
In this kind of arrhythmia, if there are no contraindications to digitalis, it is the logical drug to use from its physiologic activities, slowing the heart by its action on the vagi and causing a steadier contraction of the heart; clinically this treatment is generally successful.
Many a time clinically when one-eighth grain has failed, a dose of one-fourth grain having been apparently necessary, a change to one-tenth grain has proved entirely and perfectly satisfactory. As intimated in the preceding paragraph, the diet during endocarditis must be carefully regulated.
Its recognition, however, is by no means easy, and various fallacies are to be guarded against in applying this test clinically. When, for example, the walls of the abscess are thick and rigid, or when its contents are under excessive tension, the fluid wave cannot be elicited.
Kuhn presents an exhaustive analysis of 73 cases of congenital defects of the movements of the eyes, considered clinically and didactically. Some or all of the muscles may be absent or two or more may be amalgamated, with anomalies of insertion, false, double, or degenerated, etc. The influence of heredity in the causation of congenital defects of the eye is strikingly illustrated by De Beck.
It is in keeping with this that clinically we note how frequently spasmophilia and rickets occur in the same child. In some families the condition recurs through many generations. For our present purpose the examination of some common neuroses of nursery life it would be out of place to enter into a detailed consideration of this disorder of spasmophilia as a whole.
Clinically we know that many patients after serious illness never again have perfect circulatory strength. Other patients almost die of heart failure and yet apparently absolutely recover their ability to do hard physical work.
A sudden rise of temperature is usually associated with a feeling of chilliness down the back and in the limbs, which may be so marked that the patient shivers violently, while the skin becomes cold, pale, and shrivelled cutis anserina. This is a nervous reaction due to a want of correspondence between the internal and the surface temperature of the body, and is known clinically as a rigor.
Treatment: I believe that contrasting treatments is the very best way to teach; however, this plan is not so good when carried on in writing as it would be clinically. In order to contrast my treatment with the best just now available I shall quote from one of the latest authorities, "Modern Clinical Medicine Diseases of the Digestive System." Edited by Frank Billings, M. D., of Chicago.
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