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other, perhaps having to use the hands to accomplish this. On movement
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the course can be followed for a short time. Knowledge bas^ only upon
constipation. Persistent backache is incompatible with a sound state of
Not infreauently there are no subjective symptoms produced, and in one
being normal or but moderately diseased. Calculous anuria is one of the
~ riiiisi(lfr!il(l,\ lii'liiw till' niiriiiiil I)iii'iii'.' tin' si'i-ninl jii'iinil uf mils
definitely to the paranephric region, pain usually being the first symptom.
Treatment. — ^The treatment is operative, by extirpation or partial thyroid-
iiid liiatheiiiatically expresseil liy the n spiratur.x (pldtiellt ( pairc "'47).
.\ (luid contaiiiinjr a liijih eoiicentration of aiitithromliin is secreted
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IS not always general, and there may be marked loss of cartilage in local
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l-.'i-.-nt \M.|-K.|-s ill-,-, li..\. .'M'l', iii,-iiii,..| In .pii'sti.iii the si._'iiilirail<'r III
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'ocding those in which they should have I)oeoiiic full grown, that
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ol.\ ioiis thai it \ill •.'lion lii'iiiL' s\ ntliisi/fil liy tlic i-cai-lioii. Tims, in tli
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Mocous Membranes. — One-half the cases in my series had involvement
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line in chart 1 ; it !• ran often in ten minutes, and so,.n l.ecame almndant,
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necessary. When the results are negative, the latter test may be advisable.
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diagnosis, but ako in regard to tne particular form of arthritis deformans
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definite value. Tuberculosis and syphilis have their specific causes. The
talion of the s|ilanclinic hlood vessels; for examiile, as the I'esult of sc
of the remarkable phenomenon of localized oedema occurring in several
of neuritis, anaesthesia or other disturbance of sensation, disturbance of
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in whom the bladder was not involved, and in 18 of 36 where it was exten-
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unwelcome consequence as severe ptyalism and great debility,
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were the skin b very loose, eyelids and prepuce for example, blebs may
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tain inllueii,,e, .hpen-lin- pri.hahly on the a.-liv mass of irroMini: pn^'
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fibrous tissue explains the small size of the organ and its hardness. Brad-
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" ai.' ina.l. ..f tl,.. av.ia^e m.Iuiii.' .,f th,. ii,hil aii ,,.,■. air in larc'
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In intermediate periods the multinucleated giant cells are often one of the
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)isyeliic affair, whereas the Inmu'cr contractions depend tijion a loca'
of cases, besides deranging digestion ; in persistent, intractable cases, where
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In some cases the symptoms of arthritis are conspicuous, but the joints
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nesrative to the apex, «ivinir ns the marked upward wave, 1{. wiiich
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a clinical classification of the cases. An attempt to group them etiologically
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so that the hlooil (imls its way from riirlit to left heart
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associated with recognizable ailments often serious, although usually curable.
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part of the srut. This dijiestion, as we shall sec later, does not depeiid
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.iiiiino aciils from tiie intestinal contents into the bloo<l. It insures the
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the deficiency in their amino acids. In the ease of cliadiii of wheat "i

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