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•404 In spondylolisthesis, the mechanical disturbance produced by the slipped vertebra is added to the strain of supporting* the weakened area. Whenever either prespondylolisthesis or spondylolisthesis of the articulation of the first and second sacral vertebrae occurs coincident with lumbarization of the first sacral vertebra, the mechanical disturbance is markedly exaggerated. Such a combination is, however, relatively rare. A wedged vertebra, through the production of either scoliosis or kyphosis, may produce postural strain of other segment levels; it may also produce torsional strain, if the wedging be in the oblique plane. Developmental anomalies of the pelvis, lower extremities, dorsal, or cervical region may create low-back strain through the postural situations they produce. Low-back pain may thus be due to a tilted pelvis, a spinal list, a shoulder droop, or a torticollis as readily as to an anomaly of the lumbosacral region. Routine roentgenologic studies prove that many congenital anomalies of the spine may exist asymptomatically. Whenever backache and spinal anomaly co-exist, however, the probable causal relationship between the structural defect and the clinical picture must be considered. Summary Congenital anomalies of the lumbosacral spine may be responsible for weakness and strain of the lower back. Certain other congenital anomalies may contribute to low-back strain through the postural situations they produce. The structural weakness represented by congenital spinal anomaly may be a predisposing factor in the development of clinical symptoms. Allowing- the patient to talk. Although time consuming it is important to allow the patient to tell his story with as few interruptions as possible because in this way important associations are obtained and the ground work laid for a good relationship with the patient. Occasionally the patient has to be led back to a discussion of the present illness, but aside from such interruptions it is best to allow him to tell the story in his own way. Then one may go over the history in chronologic order with questions regarding the very first evidences of illness.—Edward Weiss: Psychosomatic Diagnosis, Am. Practitioner 1:160 (Nov.) 1946. July,. 1947 MILK SICKNESS J. T. Doyle, M.D. Grace Hospital Banner Elk Milk sickness is an intoxication in human beings which is caused by the ingestion of milk and milk products of cowts which have eaten white snakeroot (Eupatorium urticae-folium) or rayless goldenrod (Aplopappus heterophyllus). It may be acute or subacute, and probably may become chronic or relapsing. The primary intoxication in animals is known as "trembles" or "split-tail." Hardin's report in 1934 reviewed his experience with milk sickness at this hospital(1). Since this report was published, 21 additional cases have been seen here. Between 1941 and 1946 only one patient with acute milk sickness was admitted, but in the past year we have seen 3 cases of this disease, with one fatality. Case Reports Case 1 W. L. P., a white farmer 53 years of age, entered Grace Hospital on August 18, 1946. During the preceding five weeks he had suffered from severe and persistent nausea, loss of appetite, weakness, and obstinate constipation. The presence of white snake-root on his farm was denied; milk sickness had not occurred there for at least fifty years. No other member of his family was suffering from similar symptoms, but it was noted that he alone had a decided predilection for cream and butter. Some days prior to admission barium studies of the stomach and gastric analysis were performed in the hospital clinic, with negative findings. The diagnosis of milk sickness was then made, and the ingestion of brandy and honey to the noint of intoxication was prescribed. Three days of such treatment at home was unavailing because of violent emesis and increasing prostration. The patient was then brought to the hospital. The outstanding physical findings on admission were paroxysmal unproductive retching, considerable dehydration, and alcoholic intoxication. Routine laboratory determinations were normal. Large Quantities of brandy were given by gavage, and infusions of glucose were given by vein. Treatment was discontinued on the third hospital day, and he was able to tolerate a liquid diet without vomiting. He was discharged on August 23, 1946. At last renort, six months later, he remains weak, listless, without appetite, and unable to engage in strenuous work. Case 2 H. J., a 3-year-old white boy, was brought in coma to Grace Hospital on November 8, 1946. For three days he had been languid and without appetite, and for two clays he had vomited copiously. Shortly Read before the Avery County Medical Society. April 25, 1917. 1. Hardin. R. H.: Milk Sickness, Virginia M. Monthly <il: 528-531 (Dec.) 193 1. NORTH CAROLINA MEDICAL JOURNAL
Object Description
Rating | |
Fixed Title * | NCHH-17: North Carolina Medical Journal [1940-2001] |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1947 |
Identifier | NCHH-17-008 |
Form General | Periodicals |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 8 |
Health Discipline | Medicine |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-008.pdf |
Document Sort | all; nchh-17 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-008 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Description
Fixed Title * | Page 406 |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1947 |
Identifier | NCHH-17-008-0416 |
Form General | Periodicals |
Page Type | all; article; article title |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Filename | northcarolinamed81947medi_0416.jp2 |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 8 |
Issue Number | 7 |
Page Number | 406 |
Health Discipline | Medicine |
Full Text |
•404
In spondylolisthesis, the mechanical disturbance produced by the slipped vertebra is added to the strain of supporting* the weakened area.
Whenever either prespondylolisthesis or spondylolisthesis of the articulation of the first and second sacral vertebrae occurs coincident with lumbarization of the first sacral vertebra, the mechanical disturbance is markedly exaggerated. Such a combination is, however, relatively rare.
A wedged vertebra, through the production of either scoliosis or kyphosis, may produce postural strain of other segment levels; it may also produce torsional strain, if the wedging be in the oblique plane.
Developmental anomalies of the pelvis, lower extremities, dorsal, or cervical region may create low-back strain through the postural situations they produce. Low-back pain may thus be due to a tilted pelvis, a spinal list, a shoulder droop, or a torticollis as readily as to an anomaly of the lumbosacral region.
Routine roentgenologic studies prove that many congenital anomalies of the spine may exist asymptomatically. Whenever backache and spinal anomaly co-exist, however, the probable causal relationship between the structural defect and the clinical picture must be considered.
Summary
Congenital anomalies of the lumbosacral spine may be responsible for weakness and strain of the lower back.
Certain other congenital anomalies may contribute to low-back strain through the postural situations they produce.
The structural weakness represented by congenital spinal anomaly may be a predisposing factor in the development of clinical symptoms.
Allowing- the patient to talk. Although time consuming it is important to allow the patient to tell his story with as few interruptions as possible because in this way important associations are obtained and the ground work laid for a good relationship with the patient. Occasionally the patient has to be led back to a discussion of the present illness, but aside from such interruptions it is best to allow him to tell the story in his own way. Then one may go over the history in chronologic order with questions regarding the very first evidences of illness.—Edward Weiss: Psychosomatic Diagnosis, Am. Practitioner 1:160 (Nov.) 1946.
July,. 1947
MILK SICKNESS
J. T. Doyle, M.D.
Grace Hospital Banner Elk
Milk sickness is an intoxication in human beings which is caused by the ingestion of milk and milk products of cowts which have eaten white snakeroot (Eupatorium urticae-folium) or rayless goldenrod (Aplopappus heterophyllus). It may be acute or subacute, and probably may become chronic or relapsing. The primary intoxication in animals is known as "trembles" or "split-tail."
Hardin's report in 1934 reviewed his experience with milk sickness at this hospital(1). Since this report was published, 21 additional cases have been seen here. Between 1941 and 1946 only one patient with acute milk sickness was admitted, but in the past year we have seen 3 cases of this disease, with one fatality.
Case Reports
Case 1
W. L. P., a white farmer 53 years of age, entered Grace Hospital on August 18, 1946. During the preceding five weeks he had suffered from severe and persistent nausea, loss of appetite, weakness, and obstinate constipation. The presence of white snake-root on his farm was denied; milk sickness had not occurred there for at least fifty years. No other member of his family was suffering from similar symptoms, but it was noted that he alone had a decided predilection for cream and butter.
Some days prior to admission barium studies of the stomach and gastric analysis were performed in the hospital clinic, with negative findings. The diagnosis of milk sickness was then made, and the ingestion of brandy and honey to the noint of intoxication was prescribed. Three days of such treatment at home was unavailing because of violent emesis and increasing prostration. The patient was then brought to the hospital.
The outstanding physical findings on admission were paroxysmal unproductive retching, considerable dehydration, and alcoholic intoxication. Routine laboratory determinations were normal. Large Quantities of brandy were given by gavage, and infusions of glucose were given by vein. Treatment was discontinued on the third hospital day, and he was able to tolerate a liquid diet without vomiting. He was discharged on August 23, 1946. At last renort, six months later, he remains weak, listless, without appetite, and unable to engage in strenuous work.
Case 2
H. J., a 3-year-old white boy, was brought in coma to Grace Hospital on November 8, 1946. For three days he had been languid and without appetite, and for two clays he had vomited copiously. Shortly
Read before the Avery County Medical Society. April 25, 1917.
1. Hardin. R. H.: Milk Sickness, Virginia M. Monthly |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-008.pdf |
Document Sort | all; nchh-17 |
Article Title | Milk Sickness |
Article Author | J. T. Doyle |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-008 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
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