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ï~~ N~7E2ELY IULLBD3d \W E - C- D jAl OF THE ouis, Mo., 1906. S. Smith. ouis, Mo., 1917_ nan. 1900. 'rth. ST. LOUIS MEDICAL SOCIETY $1.00 per An C 1 i i C I' 8.: Vol. 14. No. 17. APRIL 22, 1920 Entered as second class matter October 4, 1907, at the Post Office at St. Louis, Mo.., under the Act of Congress, March 3, 1I ouis Clinics See ney A. Ambrose c Colon. Dr. R. V. Powell tngiomata...... Francis Reder lying Joints..... M. B. Clopton Dr. Fred Bailey.agnosis of Co4 -in H. Orndoff, Chicago, Ill. uis Clinics Sec report UL 10, 1920 CASES DEATHS 8 4 2 12 33 54 20 2 463 4 55 4 33 2 28 13 715 21 Meeting of the General Society BARTSCHER AUDITORIUM 3523 PINE STREET Cyrus E. Burford, Pres. Arthur Gundlach, Secy. Meeting convenes at 8:30 p. m. Scientific Program at 8:45 p. in. Bell: Lindell 815 Kinloch: Central 6837 Tuesday, April 27, 1920 Program Furnished by the St. Louis Clinics Section 1-Reconstruction of Face and Jaws. 2-Accidental Ablation of Right Hepatic Duct During Removal of Gall Bladder.........................................................................D r. W in. T. C oughlin Carcinoma of the Caecolon............................................................................................. D r. W m. S. W iatt Painful Back (Lantern Slide Demonstration).........................................................D r. A rcher O 'R eilly these problems vary with the character of the murmur, part of the chest at which it is best heard, and its posi in the cardiac cycle. When symptoms and signs of cardiac failure are 'pres the cardiac murmur which may be heard should neve taken as sufficient evidence for the cause of the car failure, as structural changes in valves alone seldom c heart failure. Especial care must be used not to o: emphasize the systolic murmur heard at the apex of heart, or at any other portion of the precordium. The presence of mitral stenosis and aortic i~nsufficiei both giving rise to diastolic murmurs are always of mi significance, but even when these lesions are present, it n be kept in mind that the diagnosis of valvular heart ksi should be considered as only part of the larger and m important probler" of cardiac failure. It is necmary consider the heart as a whole, arn organ in whichA myocardium is of prime importance, in arriving at cc clusions on which prognosis and treatment are based. 0) 0 - ~0 t!) 0 0 CU E -0 C ca co 0. -o 'U) CV '0 co) 0 C 0 Co z ) 10 0 Cu) 1) C ~0.) CB) 1 0) (U The Diagnosis of Chronic Myocarditis* DR. FRANK N. WILSON Author's Abstract Valvular Heart Disease DR. G. CANDY RoBINSON Author's Abstract The discovery of a cardiac murmur is the most important event in the diagnosis of valvular heart disease. Although this discovery opens the subject of valvular disease in a patient under discussion, it by no means closes it. Many problems immediately present themselves for solution and *Read before the St. Louis Medical Society, April 13, 1920. If by the term chronic myocarditis we mean that the heo muscle on examination will show degenerative changes - fibrosis, then myocarditis is difficult to diagnose; but if, t term is used to indicate only that there is something wro with the myocardium which has already interfered or w probably in future interfere with its function, myocarditis m be correctly diagnosed in the majority of cases. If chro myocarditis is used in this sense, most patients with aotic insufficiency or stenosis, with mitral stenosis, or with aortjie aneurysm, more especially those with great cardiac enlarge *Read before the St. Louis Medical Society, April 13, 1920. /

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