recommend as a good risk, an applicant whose urine
shows numerous renal cells. The same holds good
of white blood corpuscles. A few may not be of
any significance, yet a considerable number of them
found on microscopical examination will certainly
serve as a warning signal to the examiner. Many
pathologists do not ascribe any great significance to
cylindroids. To my mind, based on examination of
thousands of specimens, they are practically always
significant of renal involvement and should induce
further investigation of the applicant's health.
Of other body fluids to be examined, I Mesterolone Online consider
the blood next in importance. Careful differential
count may enable one to discover chronic conditions
of serious import. In a case recently seen by me,
my attention was attracted by the low hemoglobin
and the numerous nucleated reds which appeared in
the smeared specimen. The blood examination was
made at the request of the patient because of a feel-
ing of languor and because, being employed in a
hospital, he "just wanted to know how the blood
was." After these blood findings the urine was ex-
amined, with practically negative results. But an
examination of the gastric contents showed a total
absence of free hydrochloric acid, the presence of
considerable amount of lactic acid, the absence of
ferments, and microscopically the presence of sarci-
nge, yeast cells, Boas Oppler bacilli, etc., etc. The
Rontgen picture showed extensive involvement of
the posterior wall of the stomach along the lesser
curvature mostly and extending to the pyloric ori-
fice. Exploratory laparotomy showed an inoperable
extensive carcinoma. Yet this case had given no
clinical evidence of disease and I venture to say that
this patient could, at that time, have successfully
passed an examination for life insurance.
Modern serology has placed in our hands a reli-
able test for diagnosis of syphilis. Need any one
discuss the importance of syphilitic infection and its
relation to life expectancy? Yet not a single insur-
ance company demands a Wassermann complement
May IS. igiS-]
deviation test from any of its applicants, no matter
how high the insurance asked for may be.
In conchision, I wish to emphasize the importance
of compulsory reexamination of the insured as a
prophylactic measure. Many companies through
the life extension society are now giving their pol-
icy holders the benefit of free reexaminations. Com-
pulsory reexamination would undoubtedly benefit
both the insured and the insurer.
I. SIMON, C. E. : Manual of Clinical Diagnosis, p. 350. 2. OS-
LER. WILLIAM, and McCRAE, THOMAS: Modern Med., vi, p. 26.
3. Ibidem, p. 40. 4. Ibidem, p. 44. Generic Mesterolone 5. EMERSON, CH.: Clinical
Diagnosis, p. 169.
202 West io/Th Street.
LETTER FROM SERVIA.
Typhus among the American surgeons. — Character-
istics of the disease. — Attempts at prophylaxis.
— Treatment of the victims. — Needs of the
Seri'tan hospital units. — A cry for help. .
Skoplje, Servia, April 20, 19 15.
In my last letter I stated that our unit lost two
members in one week, one surgeon and one nurse.
The other members, including myself, had relapsing
typhus, and all are well, so far. This infectious dis-
ease caused by the invasion of the spirochete of
Obermeier, gave us much trouble ; the hospital being
at one time ftill of it and the contagion seemed to
last as long as the newly wounded came from the
trenches, being not clean and with lice in their shirts
and on the body, and even in their bandages applied
on the field of battle. This epidemic subsided and
another came, with still another in waiting.
Typhus fever or exanthematic typhus came in its
acute form, infectious, febrile, and highly contagious.
The invasion of this epidemic was sudden, with pro-
found depression of the vital powers of all the pa-
tients, especially the prisoners of war, housed to-
gether in unclean places, overcrowded, unventilated,
and under absolutely insanitary conditions, with a
diet to which many were not accustomed. At first
we blamed the prisoners of war, that they caused us
to suflfer from this Oriental plague. Then we
thought it over, looking over their barracks and not-
ing especially the bad supply of water, and blamed
a special infecting germ, the character of which was
not exactly known, but wdiich was certainly in-
fluenced by filth and overcrowding. When the mor-
tality in February went up to eighty per cent, at
some places, when the physicians and surgeons, ex-
hausted as they were in taking care of thousands of
wounded, gave their first offerings upon the altar of
humanity — we lost, here and in the vicinity, about
eighty-nine of them — we had to Mesterolone Tablets think again, and
selected a commission approved by the military au-
thorities and the State, to find means to fight this
enemy worse than bullets, grenades, shrapnel, and
bombs. We found that fear Buy Mesterolone was a bad physician
and cleanliness the best medicine.
The hyperemia of the brain beginning abruptly
with a chill, was followed by violent fever, the tem-