《Signs and Symptoms Applied Pathologic Physiology and Clinical Interpration Second Edition》

1．INTRODUCTION＆Cyril M．MacBryde1

The Process of Analyzing and Interpreting Symptoms1

Past History4

Family History5

Marital History5

Social History5

Occupational History5

Interpreting Symptoms6

2．PAIN＆Cyril M．MacBryde7

Definition7

The Dual Aspects of Pain7

The Anatomy and the Physiology of Pain8

The Psychology of Pain9

Physical Responses to Pain10

The Pain Threshold11

Superficial Pain12

Deep Pain12

Central Pain15

Clinical Manifestations of Pain15

The Function of Pain17

3．HEADACHE＆Harold G．Wolff19

Headache Mechanisms19

Discovery of the Cause：Important Considerations in Diagnosis47

4．SORE TONGUE AND SORE MOUTH＆Richard W．Vilter57

The Normal Morphology and Physiology of Tongue and Mouth58

The Medical History and the Physical Examination59

Systemic Diseases that May Cause Sore Tongue and Sore Mouth59

Other Systemic Diseases71

Local Oral Lesions75

Summary77

5．THORACIC PAIN＆John R．Smith and Robert Paine81

Origin of Painful Stimuli81

Pain Arising in the Chest Wall82

Pain Arising from the Trachea，the Pleura and the Diaphragm88

Pain Arising from Organs Contained in the Mediastinum；Mediastinal Pain92

Cardiac Pain97

Aortic Pain105

Summary107

6．ABDOMINAL PAIN＆Sara M．Jordan112

Mechanism112

Characteristics115

Diagnosis118

Etiologic Classification of Abdominal Pain121

Intra-abdominal Causes121

Extra-abdominal Causes132

Conclusions133

7．BACKACHE AND BACK PAIN＆R．H．Freyberg135

Neuro-anatomic Considerations138

Causes of Back Pain140

Miscellaneous Causes of Backache153

Summary153

8．JOINT PAIN＆R．H．Freyberg155

Anatomic Considerations155

Physiologic Considerations158

Pathogenesis of Articular Pain160

Diagnostic Considerations of Joint Pain160

Monarticular Pain161

Polyarticular Pain167

Summary171

9．PAIN IN THE EXTREMITIES＆Ray David Williams173

Perspective of the Problem173

Nature and Causation of Pain in the Extremities177

False Localization of Pain(Referred Pain)194

Evaluation of Painful Sensation200

Summary201

10．CLUBBED FINGERS AND HYPERTROPHIC OSTEO-ARTHROPATHY＆Bernard S．Lipman and Edward Massie203

Terminology203

Relationship of Clubbing to Hypertrophic Osteo-arthropathy203

Recognition204

Medical Importance208

Pathology211

Pathogenesis211

Summary213

11．PALPITATION AND TACHYCARDIA＆Edward Massie217

Palpitation217

Tachycardia221

Summary233

12．COUGH＆David M．Skilling，Jr235

Definition235

Mechanism of Cough235

The Nature of the Stimuli that Produce Cough236

The Lesions in which Cough Occurs237

Summary253

13．HEMOPTYSIS＆David M．Skilling，Jr256

The Causes of Hemoptysis256

Summary259

14．DYSPNEA＆David P．Barr261

Influences upon Respiration262

General Factors that May Lead to Hyperpnea or Contribute to Dyspnea262

Clinical Classification of Dyspnea271

Hyperpnea and Dyspnea of Muscular Exercise271

Factors Contributing to Cardiac Dyspnea273

Factors Contributing to Dyspnea in Pneumonia and Atelectasis275

Factors Contributing to Dyspnea in Asthma and Emphysema275

Summary276

15．CYANOSIS＆David P．Barr280

Normal Oxygen Relationships280

Causes of Cyanosis282

Relation of Cyanosis to Accumulation of Carbon Dioxide283

The Rationale of Oxygen Therapy284

16．ANOREXIA，NAUSEA AND VOMITING＆John L．Horner287

Nerve Supply to Gastro-intestinal Tract287

Anorexia289

Nausea297

Vomiting298

Summary305

17．CONSTIPATION AND DIARRHEA＆John L．Horner310

Food Passage Through Gastro-intestinal Tract310

Causes of Constipation313

Causes of Diarrhea319

Summary324

18．HEMATEMESIS AND MELENA＆Leon Schiff328

General Considerations328

Etiology336

Physical Examination338

χ-ray Examination338

Gastroscopy341

Bleeding Peptic Ulcer343

Carcinoma of the Stomach345

Hepatic Cirrhosis347

Gastritis348

Hematemesis and Melena Due to Miscellaneous Causes349

Hiatal Hernia349

Aortic Aneurysm Rupturing into the Esophagus350

Summary350

19．JAUNDICE＆Sidney A．Portis354

Physiology of the Bile Pigments354

Definitions358

Criteria of Normal Bilirubin Level359

Classification of the Causes of Jaundice359

Obstructive Jaundice360

Hemolytic Jaundice361

Toxic or Infective Jaundice362

Differentiation of the Types of Jaundice363

The Clinical Picture in Various Types of Jaundice365

Interpretation of Laboratory Tests367

20．NERVOUSNESS AND FATIGUE＆Edwin F．Gildea372

Definitions372

Pathologic Physiology of Nervousness373

Pathologic Physiology of Fatigue374

Differential Diagnosis376

Mental Disorders376

Neurologic Conditions381

Endocrine Disorders381

Other Organic Diseases383

Nutritional Disorders383

Drug Addiction and Poisons384

Conclusion384

21．FEVER＆Paul B．Beeson386

Regulation of Body Temperature386

Body Temperature in Health389

Limits of Body Temperature Compatible with Life391

Fever：Types and Terminology391

Pathogenesis of Fever392

Metabolism in Fever392

Complications of Fever393

Spurious Fever395

Effects of Fever395

Clinical Causes of Fever395

Summary405

22．DISTURBANCES OF CONSCIOUSNESS AND OF MUSCLE MOVEMENT＆William G．Lennox409

Normal Nervous Activity409

Mechanism of Abnormal Activity412

Consciousness413

Disturbed Muscle Movements418

Disturbance of Both Consciousness and Movement423

Summary431

23．FAINTINC＆Eugene A．Stead，Jr436

Definition436

Pathogenesis436

Fainting from Arteriolar Dilatation437

Fainting from a Sharp Fall in Cardiac Output without Cardiac Standstill441

Fainting from Ventricular Standstill(Adams-Stokes Attacks)442

Reflex Fainting of Cerebral Type443

Tussive Fainting with Obstructive Emphysema，Tracheal or Laryngeal Obstruction443

Fainting from External Compression of the Thorax with Glottis Closed444

Fainting from Cerebral Anoxemia in Tetralogy of Fallot444

Fainting from Obstruction of the Common Carotid Arteries444

Fainting from Embolus Lodging in a Cerebral Artery444

Fainting from Hyperventilation444

Fainting from Anoxemia445

Fainting from Hypoglycemia445

Hysterical Fainting445

Less Well Understood Causes of Fainting446

Diagnostic Approach in Person with Chief Complaint of Fainting446

Summary448

24．VERTIGO AND DIZZINESS＆H．H．Hyland450

Definitions450

Anatomic and Physiologic Considerations452

Clinical Significance of Vertigo and Dizziness455

Summary466

25．DEHYDRATION＆Cyril M．MacBryde470

Definition470

Dehydration as a Symptom471

Water Balance471

Causes of Dehydration471

Anatomy of the Body Fluids472

Physiology of the Body Fluids475

Acidosis and Dehydration489

Alkalosis and Dehydration493

Intracellular Effects of Dehydration494

Dehydration and Renal Impairment498

Dehydration，Salt Depletion and Shock499

Parenteral Fluids in the Treatment of Dehydration500

Diuretics and Dehydration504

Cathartics and Dehydration505

Summary506

26．EDEMA＆Henry A．Schroeder509

Definition509

Physiologic Considerations510

Edema Caused by Primary Transudation of Fluids from Blood to Tissue Spaces522

Edema Caused by Primary Renal Retention of Salt and Water529

Edema Due to Unknown Causes530

Edema Due to Multiple Factors531

Summary539

27．OBESITY＆Cyril M．MacBryde544

Diagnosis544

Medical Importance of Obesity546

Obesity as a Symptom549

The Cause of Obesity549

Storage of Fat550

Fat Metabolism550

Etiology of Obesity551

Summary564

28．WEIGHT LOSS AND UNDERNUTRITION＆Cyril M．MacBryde568

Definitions568

Medical Importance of Weight Loss and Undernutrition568

Weight Loss and Undernutrition as Symptoms569

Growth：Nutritive Aspects570

Aging and Malnutrition570

The Cause of Weight Loss and Thinness570

Causes of Specific Nutritive Deficiencies572

Pathologic Physiology576

Effects of Disease on Nutrition576

Effects of Nutrition on Disease576

Clues in the History577

The Essential Foods577

The Functions of Foods578

Requirements of Specific Nutrients in Health and in Disease583

Effects of Malnutrition590

Clinical Manifestations of Malnutrition592

Malnutrition as Cause of Death601

Summary601

29．PATHOLOGIC BLEEDING＆Benjamin Alexander603

Normal Hemostasis604

Hemorrhagic Diseases621

Clinical Manifestations621

Summary652

30．PIGMENTATION OF THE SKIN＆Harold Jeghers and Edward A．Edwards666

Factors Involved in Normal Skin Pigmentation666

Patterns of Normal Skin Color679

Increased Pigmentation of the Skin684

Decreased Skin Pigmentation705

Value of Colored Illustrations in Medical Education709

Summary709

31．ITCHING(PRURITUS)＆Stephen Rothman and Arthur L．Shapiro713

Mechanism of Itching713

Analysis of Itching as a Symptom715

Generalized Pruritus721

Localized Pruritus734

Summary736

INDEX739