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Title: United States Naval Medical Bulletin Vol. 14, Nos. 1-4, 1920

Creator: U.S. Navy. Bureau of Medicine and Surgery

Publisher:

Sponsor:

Contributor:

Date: 1920

Language: eng

Table of Contents

Number 1

PREFACE V

NOTICE TO SERVICE CONTRIBUTORS VI

SPECIAL ARTICLES:

ANTHROPOMETRIC STUDY AT ANNAPOLIS.

By Lieutenant L. B. Solhaug, Medical Corps, U. S. N 1

Medical and Hygienic Aspects of Submarine Service.

By Lieutenant Commander E. W. Brown, Medical Corps, U. S. N 8

Report on Facial and Jaw Injuries.

By Lieutenant Commander L. W. Johnson, Medical Corps, U. S. N 17

Military Orthopedic Hospitals in the British Isles.

By Lieutenant R. Hammond. Medical Corps, U. S. N. R. F. 65

HISTORICAL :

Medicine in Rome 103

EDITORIAL :

The New Year — Standards of Duty 127

IN MEMORIAM :

Edward Grahame Parker.

By Captain C. E. Riggs, Medical Corps, U. S. N 135

SUGGESTED DEVICES:

Changes in Scuttle Butts Aboard Ship.

By Lieutenant Commander J. A. B. Sinclair, Medical Corps,

U. S. N. R. F 137

An Emergency Evacuation Device 145

CLINICAL NOTES :

Bronchopulmonary Spirochetosis in an American.

By Lieutenant G. W. Lewis, Medical Corps, U. S. N 149

Encephalitis Lethargica.

By Lieutenant A. F. Kuhlman, Medical Corps, U. S. N 151

Defense of the Open-Air Treatment of Pneumonia.

By Lieutenant D. Ferguson, jr., Medical Corps, U. S. N 153

NOTES AND COMMENTS :

Carbon tetrachloride poisoning. —Civil service positions. — Serum treatment

in yellow fever. —" Deer-fly disease." — Request for specimens.—

Medical personnel of the French Navy.—Centenary celebrations. —Situs inversus.

—Italian view of prohibition. — Effects of prohibition In Chicago. — Treatment

of sterility. — Pilocarpine in influenza. —A death from anesthesia.- — Free

hospital service in Oklahoma City. —Birth rate of Manila. —Expansion of the

Faculty of Medicine, Paris. —Statistics on blindness. —French eight-hour law. —

Corporation philanthropy 155

REPORTS :

The Receiving Ship Barracks, New York.

By Commander W. G. Farwell and Lieutenant R. M. Krepps, Medical Corps,

U. S. N 163

Grounding of the U. S. S. Northern Pacific.

By Lieutenant J. C. Ruddock, Medical Corps, U. S. N 185

Impressions of a Reservist.

By Commander L. R. G. Crandon, Medical Corps, U. S. N. R. F 188

Number 2

PREFACE v

NOTICE TO SERVICE CONTRIBUTORS vi

SPECIAL ARTICLES:

Types of Neurological and Psychiatric Cases.

By Lieutenant Commander E. C Taylor, Medical Corps, U. S. N. R. F 191

Yellow Fever.

By Lieutenant Commander T. Wilson, Medical Corps, U. S. N 200

Asepsis of Abdominal Incisions.

By Lieutenant Commander F. H. Bowman, Medical Corps, U. S. N 208

Calcium Chloride Intravenously for Hemoptysis.

By Lieutenant Commander W. H. Fickel, Medical Corps, U. S. N 210

Hospital Records 213

HISTORICAL:

The Arabians and the First Revival of Learning 225

SUGGESTED DEVICES:

Hospital Garbage Disposal.

By Captain A. Farenholt, Medical Corps, U. S. N 237

The Flat-Foot Ladder 240

CLINICAL NOTES:

Chondrodysplasia with Exostoses.

By Lieutenant R. W. Hutchinson, Medical Corps, U. S. N 243

A Case of Vascular Syphilis.

By Lieutenant A. E. Kuhlmann, Medical Corps, U. S. N., and Lieutenant

Commander C. C. Ammerman, Medical Corps, U.S.N.R. F 245

Two Cases of Encephalitis Lethargica.

By Lieutenant Commander R. I. Longabaugh, Medical Corps, U. S. N 249

A Case of Foreign Body in the Head.

By Lieutenant Commander L. M. Schimdt, Medical Corps, U. S. N. 254

The Late Treatment of War Osteomyelitis.

By Lieutenant E. I. Salisbury, Medical Corps, U. S. N. R. F 255

Two Cases of Gas Gangrene.

By Lieutenant Commander L. M. Schmidt, Medical Corps. U. S. N 257

Gastric Ulcer with Perforation.

By Lieutenant G. G. Holladay, Medical Corps, U. S. N. R. F 259

Internal Ophthalmoplegia.

By Lieutenant Commander E. E. Woodland, Medical Corps, U.S.N 260

Open Treatment of a Fractured Metacarpal Bone.

By Lieutenant R. W. Auerbach, Medical Corps, U. S. N 263

Supernumerary Phalanx.

By Lieutenant R. S. Reeves, Medical Corps, U. S. N. R. F 265

A Cask of Ruptured Kidney.

By Commander K. It. Richardson, Medical Corps, U. S. N

Mustard Gas and the Cardiovascular System.

Ry Lieutenant Commander W. H. Michael, Medical Corps, U. S. N

A Case of Ulcer of the Sigmoid Flexure.

By Lieutenant H. R. Coleman, Medical Corps, U. S. N

A Case of Malposition.

By Lieutenant A. C. Toll inner, Dental Corps, U. S. N

PROGRESS IN MEDICAL SCIENCES :

General Medicine — Blood pressure and posture —Intramuscular Injections

of quinine in malaria — Vincent's disease Surgery — Appendicitis amongst

sailors— Transplanting of bone— Rectal ether anesthesia

Hygiene and Sanitation — Destruction of lice by steam

Eye, Ear. Nose, and Throat — Ocular phenomena in the psychoneuroses of

warfare —Ocular complications due to typhoid inoculations

NOTES AND COMMENTS:

Syphilis and the war—Bone surgery —National Research Council— Laboratories

in Poland— National Anaesthesia Research Society — Vanderbilt Medical School —

Municipal education in Detroit — Female medical matriculates— Degrees conferred

by Royal College of Surgeons of Edinburgh — Speech defects — Typhoid fever in

New York — Venereal diseases in California- — Omissions in the Annual Report of

the Surgeon General, 1919

REPORTS :

U. S. Navy Ambulance Boat No. 1.

By Chief Pharmacist's Mate D. V. De Witt, U. S. N

Physical Development in the Navy.

By Lieutenant B. G. Baker, Medical Corps, U. S. N

Venereal Prophylaxis at Great Lakes, III.

By Lieutenants D. It. Blender and L. A. Burrows, Medical Corps, U. S.

N. R. F

Report of 505 Tonsillectomies.

By Lieutenant W. P. Vail, Medical Corps, U. S. N. R. F

BOOK NOTICES

Number 3

PREFACE v

NOTICE TO SERVICE CONTRIBUTORS vi

SPECIAL ARTICLES :

History of the U. S. Naval Hospital, Chelsea, Mass.

By Captain N. J. Blackwood, Medical Corps, U. S. N 311

INSTRUCTION FOR THE HOSPITAL CORPS.

By Lieutenant Commander W. M. Kerr, Medical Corps, U. S. N. 338

Study of Two Cases of Diabetes Mellitus.

By Lieutenant L. F. Craver, Medical Corps, TJ. S. N 345

Flat Foot in the Navy.

By Lieutenant C. F. Painter, Medical Corps, U. S. N. R. F 359

Static Defects of the Lower Extremities.

By Lieutenant A. A. Marsteller, Medical Corps, U. S. N 365

Treatment of Malaria.

By Lieutenant Commander W. H. Michael, Medical Corps, U. S. N 367

Navy Recruiting.

By Lieutenant W. H. Cechla, Medical Corps, U. S. N 371

HISTORICAL:

American Founders of Gynecology 373

EDITORIAL :

"Bring Forth Your Dead "—Is Educational Prophylaxis Effective

381

William Martin —John Wolton Ross —Oliver Dwight Norton, Jr 389

CLINICAL NOTES:

Interdental Ligation for Jaw Fractures.

By Lieutenant W. F. Murdy, Dental Corps, U. S. N 391

A Temporary Stopping.

By Lieutenant Commander H. E. Harvey, Dental Corps, U. S. N 394

ASCARIASIS AND APPENDICITIS.

By Lieutenant Commander E. G. Hakansson, Medical Corps, U. S. N 394

Malarial Crescents.

By Lieutenant Commander W. H. Michael, Medical Corps, U. S. N_ 395

Poisoning by Jelly Fish.

By Commander A. H. Allen, Medical Corps, U. S. N 396

Traumatic Rupture of Kidney.

By Lieutenant Commander F. H. Bowman, Medical Corps, U. S. N 397

A Case of Erythema Multiforme.

By Lieutenant M. F. Czubak, Medical Corps, U. S. N 399

PROGRESS IN MEDICAL SCIENCES:

General Medicine. — Static back trouble—Benzyl benzoate —Relation of

anaphylaxis to asthma and eczema —High enema —Treatment of typhus —Thilerium

hominis 401

Mental and Nervous Diseases. —Insanity as a defense in crime —The nervousness

of the Jew— The Babinski reflex —Problems of delinquency —Encephalomyelitis in

Australia 408

Surgery. — Radium — Surgery of peripheral nerves — Referred symptoms in

diseases of gall-bladder and appendix—Intracranial pressure —Protection of the

skin in surgical operations—Anesthesia

from drugs administered by the mouth —A new skin-suture material —

Roentgen-ray problems , 414

Hygiene and Sanitation. — Birth control—Typhoid fever in vaccinated

troops —Detection of typhoid carriers —Streptococci in market milk

—Tuberculosis in San Francisco —An experiment in sanitary education —Oral

hygiene —Differential diagnosis between trachoma and follicular conjunctivitis

—Left - handedness —The Negritos of the Philippine Islands —Tropical Australia

425

NOTES AND COMMENTS :

American Society for the Control of Cancer — Pay of Italian medical officers

— The passing of the book worm— The neurotic girl —Control of druggists in

Michigan — English statistics on alcoholism —Prevention of simple goiter— Value

of quarantine against influenza in Australia —W. P. C. Barton, first chief of

the Bureau of Medicine and Surgery—Information on blood-pressure estimation

—Automobile accidents —Egyptian Medical School — Educational movement In U. S.

Army 443

REPORTS :

Health Conditions in Santo Domingo.

By Lieutenant Commander G. F. Cottle, Medical Corps, U. S. N 453

History of U. S. S. Pocahontas During the War,

By Lieutenant Commander M. Boland, Medical Corps, U. S. N 460

With the American Peace Commission.

By Commander A. D. McLean, Medical Corps, U. S. N 500

Testing Water for Storage Batteries.

502

Report from Naval Medical School Laboratory 505

BOOK NOTICES 505

Number 4

PREFACE V

NOTICE TO SERVICE CONTRIBUTORS VI

SURGICAL ACTIVITIES AT THE NAVAL

HOSPITAL, NEW YORK.

Interesting bone cases 512

Fractubes of the anterior tuberosity of the tibia and Osgood-Schlatter's

disease 516

Carrel-Dakin technique for empyema 527

Physical therapy 535

Occupational therapy 536

War wounds of the joints.

By Dr. L. Delrez, Faculty of Medicine Liege 537

A case or joint treatment by Willems's method 545

Chronic intestinal stasis 545

Carrel-Dakin technique in treatment of carbuncle 549

A case of sarcoma of the foot 550

A case of Jacksonian epilepsy with spastic contracture 551

A Case Of Osteoma Of The Humerus 552

A Case Of Bone Infection Resembling Sarcoma 552

Wound closures after Carrel-Dakin treatment 553

Ether in peritonitis 557

HISTORICAL:

The founders ok naval hygiene. Lind, Trotter, and Blane 563

EDITORIAL:

Hospital standards —As seen from within 629

SUGGESTED DEVICES :

Vision test apparatus.

By Lieutenant Commander H. W. Glltner, Medical Corps, U. S.N. R. F 637

Treatment of cement floors.

By Captain A. Farenholt, Medical Corps, U. S. N 638

CLINICAL NOTES:

Ophthalmitis in secondary syphilis.

By Lieutenant Commander W. H. Whitmore, Medical Corps, U. S. N 639

TWO CASES OF OPTIC ATROPHY.

By Lieutenant Commander C. B. Camerer, and Lieutenant G. L. McClintock,

Medical Corps, U. S. N 641

Arsphenamine in malaria.

By Lieutenant Commander W. H. Michael, Medical Corps, U. S. N 643

Ureteral calculus.

By Commander W. J. Zalesky and Lieutenant Commander P. F. Prioleau,

Medical Corps, U. S. N 644

PROGRESS IN MEDICAL SCIENCES :

General medicine. — Treatment of respiratory catarrhs.—Tests of thyroid

hypersensitiveness. —A diet sheet for nephritics.— Delayed arsenical poisoning

647

Surgery. —Open treatment of fractures. — Treatment of crushed extremities.

—Nerve injuries of the war 653

Hygiene and sanitation. —Disinfection of tubercular sputum. — Syphilis

in railroad employees 659

Tropical diseases. —Ulcerating granuloma 663

Eye, ear, .nose, and throat. — Frontal sinus drainage. —Anesthetics in throat

surgery. —Correction of nasal deformities

NOTES AND COMMENTS :

American Library Association.— Mental defects in the United States. —

"Tea-taster's " cough. — Scientific basis of carelessness. — "The

case against the prophylactic packet." —Treatment of leprosy. — Medical

training in London. —A new Army and Navy Club. — The Navy Mutual Aid

Association. — Medical school of the University of Virginia. —A new medical

quarterly. —Solar therapy. — Novarsenobenzol subcutaneously. —Economic loss

from rats. —The flight of mosquitoes. —A medical centenarian. — A French hospital

ship. — Potassium-mercuric-iodide.— Dermatitis in industrial work. —

Radium.— A twelfth century epitaph 663

REPORTS :

Arsenical preparations used intravenously.

By Captain E. S. Bogert, Medical Corps, U. S. N 679

Venereal disease in the Dominican Republic.

By Lieutenant J. W. Vann and Lieutenant B. Groesbeck, Medical Corps, U.

S. N 681

American legation guard, Managua, Nicaragua.

By Lieutenant Commander F. F. Murdock, Medical Corps, U. S. N_ 684

Sanitary conditions in Vladivostok.

By Lieutenant A S. Judy, Medical Corps, U. S. N 689

Hospital records.

Commander H. W. Smith, Medical Corps, U. S. N 698

HOSPITAL RECORDS.

By Commander E. U. Reed, Medical Corps, U. S. N 706

A DEATH FROM ETHER DUE TO STATUS LYMPHATICUS.

By Captain A. W. Dunbar, Medical Corps, U. S. N 714

Medical prophylaxis against venereal diseases.

By Lieutenant P. W. Dreifus, Medical Corps, U. S. N 715

BOOK NOTICES 718

INDEX 721

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Beatle in metallic edition? by John de Grooth

15 34

Bug in metallic edition? "How close can you get?" nr 39

More "How close can you get?" CLICK HERE

More in first comment.

Dutch

Rietkever hier in actie als rietdekkers...|;-))

Wiki

Soorten uit het geslacht Plateumaris zijn lastig te onderscheiden.

Uiterlijke kenmerken

Lichaamsdelen van de gewone rietkever (Donacia vulgaris).

A = Kop

B = Borststuk

C = Achterlijf

1 = Antenne

2 = Oog

3 = Halsschild

4 = Voorpoot (femur)

5 = Middelste poot (tibia)

6 = Achterpoot (tarsus)

7 = Dekschild

Net als andere insecten bestaat het lichaam uit drie delen; een kop, een borststuk en een achterlijf. De kever heeft verder twee duidelijk zichtbare antennes, drie paar poten en twee paar vleugels, de bovenste zichtbare vleugels hebben een meestal groene kleur met een metaalachtige glans die verschillende tinten kan hebben. De lichaamslengte exclusief uitsteeksels zoals poten en antennes ongeveer een centimeter lang, de lichaamslengte kan verschillen per soort maar is maximaal ongeveer een centimeter. De gewone rietkever (Donacia vulgaris) bereikt een lichaamslengte van 6 tot 8 millimeter,[4] de soort Donacia aquatica wordt ongeveer 6 tot 10 mm lang.[5]

De kop of cephalon is relatief klein en draagt verschillende aanhangsels. Aan de voorzijde van de kop zijn de antennes gelegen. De antenenes zijn draadvormig (filiform) en zijn duidelijk gesegmenteerd. Aan het uiteinde van ieder segment is een verdikking aanwezig, het laatste lid is iets verdikt maar niet knopvormig zoals bij andere insecten voorkomt. De ogen zijn rond en kraalachtig en vaak donkerder tot zwart van kleur.

Het borststuk of thorax is het gecompliceerdste deel van het lichaam van de kevers. Het borststuk lijk uit één geheel te bestaan maar is in feite een samensmelting van drie delen. De verschillende delen van het borststuk worden van voor naar achter het propleuron, het mesopleuron en het metapleuron genoemd. Ieder deel draagt een paar poten aan de onderzijde en de twee voorste delen dragen ieder een paar vleugels aan de bovenzijde.

Net als andere kevers is het borststuk is het deel waaraan alle poten en vleugels zijn gehecht. Het voorste deel van het borststuk wordt beschermd door het halsschild of pronotum en het achterste deel is onder de dekvleugels of elytra gelegen. Het pronotum is sterk gewelfd, in het midden is een groef aanwezig in de lengte en aan weerszijden zijn enkele bulterige structuren aanwezig.

De dekschilden zijn langwerpig en eindigen spits, ze hebben een groene kleur met een duidelijke metaalglans. De dekschilden zijn voorzien van rijen talrijke kleine putjes. Deze breken het licht zodat ze lijken op rijen kleine vlekjes.

De poten bestaan net als andere kevers uit drie delen, die afwijken ten opzichte van andere kevers. De poten zijn lang en sprieterig, iets wat bij de meeste verwante bladhaantjes ontbreekt. Het eerste deel van de poot wordt de heup of coxa, deze pootbasis is aan de onderzijde van het lichaam gepositioneerd en moeilijk te zien. De heup is middels de dijbeenring of trochanter verbonden met de overige drie delen van de poot, die wel onder de dekschilden uitsteken en duidelijk te zien zijn. Het eerste deel is de dij of femur, de dij eindigt in een verdikking.

De mannetjes hebben aan de tibia van het achterste potenpaar een duidelijk stekelachtige structuur die naar achteren wijst een een spoor wordt genoemd. De sporen spelen een rol bij de paring van de kevers, de mannetjes ankeren zich met behulp van de sporen aan een vrouwtje. Sporen komen ook wel bij sommige andere kevers voor, maar de rietkevers zijn aan deze uitsteeksels makkelijk te onderscheiden van gelijkende kevers.

Het achterlijf of abdomen is het grootste deel van het lichaam, het wordt geheel verborgen onder de dekschilden. Het achterlijf is gesegmenteerd en wordt beschermd door verstevigde platen. De platen aan de bovenzijde van het achterlijf worden de tergieten genoemd en die aan de onderzijde van het achterlijf zijn de sternieten. aldus wikipedia

12A_0318XACCN

Vou levá- by Israel González

8 1

rozar con la yema de tus dedos

la superficie tibia de un cristal

una y otra vez miles de veces

rub with your fingertips

the warm surface of a glass

and over a thousand times

House cricket / Heimchen / Acheta domesticus by Matthias Lenke

51 44

A house cricket (Acheta domesticus) climbs over a bread bun. Magnification at 2,1x on FF-sensor, slightly cropped.

Taken with Canon EOS 5D and Schneider Componon-S 35mm/f4 reversed on bellows, flash, paper cylinder diffuser; stacked with Zerene, mix of DMap & PMax method.

Mr. Tibias. by Dal Lee

4 1

Seashell - tibia insulaechorab / arabian tibia by Stephen Mulligan

8 3

Tibia - 1º Knight Lvl 300 Free Account by Bruno Geraldi

Gladera - Venom Vic

Shinbone Tibia (4) by CK Lee

2 45

TÍBIA DE TITANOSSAURO by J. Garcia

DESCOBERTAS PALEONTOLÓGICAS NO SÍTIO DE PEIRÓPOLIS EM UBERABA-MG.

Desde a década de 1940, descobertas paleontológicas já traziam nova notoriedade para a região. Informado de que fósseis de ossos haviam sido encontrados durante obras de retificação da linha da linha férrea Mogiana, o paleontólogo gaúcho Llewellyn Ivor Price (1905-1980), começou a trabalhar em Peirópolis em 1947. Realizou uma escavação sistemática na região de Caieira, entre 1949 e 1961. Como resultado, foram recuperadas centenas de ossos fossilizados do período Cretáceo Superior (100 a 65 milhões de anos atrás), sobretudo de dinossauros do grupo dos titanossauros.

Por quase 30 anos, o Ivor Price pesquisou as terras do Triângulo Mineiro e de municípios paulistas. Considerado o pai da paleontologia brasileira, permaneceu na região até 1974. Todo o acervo de fósseis coletado por ele e seus auxiliares, ao longo de três décadas, integra a coleção do Museu de Ciências da Terra do Departamento Nacional de Produção Mineral (DNPM), no Rio de Janeiro.

Museu e Centro de Pesquisas.

Em 1991, a Prefeitura Municipal de Uberaba restaurou o prédio da estação e outras dependências no entorno para instalar o "Centro de Pesquisas Paleontológicas Llewellyn Ivor Price", criado no ano seguinte sob supervisão do geólogo Luiz Carlos Borges Ribeiro. A antiga estação passou a abrigar um laboratório de preparação de fósseis e um pequeno, mas atraente museu paleontológico, aberto à visitação pública e vinculado à Fundação Cultural de Uberaba. Outros imóveis no entorno foram transformados em residências para pesquisadores.

Dentre as atrações do museu, destaca-se hoje o esqueleto fossilizado do crocodilomorfo do Cretáceo Superior Uberabasuchus terrificus – descoberto na região no ano 2000 e um dos mais completos do tipo já encontrado no mundo – que está exposto no museu ao lado de uma réplica do animal. O Uberabasuchus terrificus pertence a uma família de crocodilomorfos denominada Peirosauridae em homenagem a Peirópolis. Estima-se que ele media aproximadamente 2,5 metros de comprimento e pesava cerca de 300 kg.

Mais recentemente foram descobertos na região fosseis do Uberabatitan ribeiroi, o maior dinossauro brasileiro já encontrado. Fósseis de três indivíduos dessa espécie foram descobertos em 2004 na região de Serra da Galga, entre as cidades de Uberaba e Uberlândia, durante a realização das obras da duplicação da rodovia BR-050. O trabalho de retirada dos fósseis foi concluído em 2006, após os técnicos escavarem manualmente cerca de 300 toneladas de rochas que datavam do período Cretáceo e Paleogeno para a extração do material. Em 2011, foram feitas novas descobertas na mesma área, que incluem um fêmur de 1,4 metros do Uberabatitan.

Rede Nacional de Paleontologia.

Em 2003/2004 o Governo Federal, por meio do Ministério da Ciência e Tecnologia, liberou recursos para a construção em Peirópolis da sede da Rede Nacional de Pesquisas Científicas em Paleontologia. Diversas controvérsias envolveram o projeto que teria como objetivo proteger sítios fossilíferos e divulgar a paleontologia.

Apesar de um grande prédio ter sido construído próximo ao antigo museu para sediá-la, a Rede Nacional nunca se concretizou e terminou extinta. Suas instalações passaram a ser utilizadas para mostras científicas, atividades lúdicas e pedagógicas sobre a paleontologia, direcionadas a crianças e estudantes de Uberaba e região. Hoje o prédio abriga um auditorio para palestras, salas para oficinas, alem da sede da Associação dos Amigos do Sitio Paleontológico de Peirópolis - AASPP. Abriga também as réplicas de um Megaterium (Preguiça Gigante) e de um Titanossauro, ambos encontrados na região.

Em 2011, o novo prédio e seus equipamentos – juntamente com o Museu e o Centro de Pesquisas – foram integrados ao novo Complexo Científico Cultural de Peirópolis vinculado à Universidade Federal do Triângulo Mineiro (UFTM) e à Secretaria de Estado de Ciência, Tecnologia e Ensino Superior de Minas Gerais.

Fonte.............. pt.wikipedia.org/wiki/Peir%C3%B3polis

-------------------------------------------------------------------

A maior atração do museu é o rico acervo de fósseis de dinossauros e outros vertebrados. Conta ainda com painéis explicativos sobre a evolução da vida e dioramas que reconstituem os cenários da vida e dos animais e vegetais que habitaram a região de Uberaba há milhões de anos. Está instalado no prédio da antiga estação ferroviária de Peirópolis, construída em 1889, em estilo inglês.

Horário de visitação: terça a sexta das 08 as 17h e sábado, domingo e feriados das 08h as 18h.

No período de janeiro (férias) o Museu também está aberto às segundas-feiras. Durante o período de Carnaval fechará apenas no dia 10 de fevereiro.

BR 262, km 784, Bairro de Peirópolis.

(34)3338-1526.

Fonte............ www.uberaba.mg.gov.br/portal/conteudo,706

//////////////////////////////////////////////

PALEONTOLOGICAL DISCOVERIES IN THE SITE OF PEIRÓPOLIS IN UBERABA-MG.

Since the 1940s, paleontological discoveries have already brought new fame to the region. Informed that bone fossils had been found during the rectification of the Mogiana railway line, Gaucho paleontologist Llewellyn Ivor Price (1905-1980) began working in Peirópolis in 1947. He performed a systematic excavation in the region of Caieira, between 1949 and 1961. As a result, hundreds of fossilized bones from the Upper Cretaceous period (100 to 65 million years ago), mainly dinosaurs from the titanosaurs group, were recovered.

For almost 30 years, Ivor Price surveyed the lands of the Triângulo Mineiro and the municipalities of São Paulo. Considered the father of Brazilian paleontology, he remained in the region until 1974. The collection of fossils collected by him and his assistants for three decades is part of the collection of the Museum of Earth Sciences of the National Department of Mineral Production (DNPM) in Rio de Janeiro.

Museum and Research Center.

In 1991, the Municipality of Uberaba restored the station building and other dependencies in the surroundings to install the "Llewellyn Ivor Price Paleontological Research Center", created the following year under the supervision of the geologist Luiz Carlos Borges Ribeiro. The old station started to house a fossil preparation laboratory and a small but attractive paleontological museum, open to public visitation and linked to the Cultural Foundation of Uberaba. Other surrounding properties have been transformed into residences for researchers.

Among the attractions of the museum, the fossilized skeleton of the crocodilomorph of the Upper Cretaceous Uberabasuchus terrificus - discovered in the region in the year 2000 and one of the most complete of the type already found in the world - is exhibited in the museum next to a replica of the animal. Uberabasuchus terrificus belongs to a family of crocodilomorphs called Peirosauridae in honor of Peirópolis. It is estimated to be approximately 2.5 meters long and weighs about 300 kg.

More recently they were discovered in the fossil region of Uberabatitan ribeiroi, the largest Brazilian dinosaur ever found. Fossils of three individuals of this species were discovered in 2004 in the region of Serra da Galga, between the cities of Uberaba and Uberlândia, during the works of the duplication of highway BR-050. The work of removing the fossils was completed in 2006, after the technicians manually excavated about 300 tons of rocks dating from the Cretaceous and Paleogene for the extraction of the material. In 2011, new discoveries were made in the same area, which include a femur of 1.4 meters from Uberabatitan.

National Network of Paleontology.

In 2003/2004, the Federal Government, through the Ministry of Science and Technology, released funds for the construction in Peirópolis of the headquarters of the National Network of Scientific Research in Paleontology. Several controversies involved the project that would aim to protect fossiliferous sites and promote paleontology.

Although a large building was built near the old museum to house it, the National Network never materialized and ended up extinct. Its facilities began to be used for scientific shows, play and pedagogical activities on paleontology, aimed at children and students of Uberaba and region. Today the building houses an auditorium for lectures, workshop rooms, and the headquarters of the Association of Friends of the Peirópolis Paleontological Site - AASPP. It also houses the replicas of a Megaterium (Giant Sloth) and a Titanosaurus, both found in the region.

In 2011, the new building and its equipment - together with the Museum and the Research Center - were integrated into the new Peirópolis Cultural Scientific Complex linked to the Federal University of the Triângulo Mineiro (UFTM) and the State Secretariat for Science, Technology and Education Superior of Minas Gerais.

Link .............. en.wikipedia.org/wiki/Peir%C3%B3polis

-------------------------------------------------- -----------------

The museum's greatest attraction is the rich collection of fossils of dinosaurs and other vertebrates. It also has explanatory panels on the evolution of life and dioramas that reconstitute the scenarios of life and of the animals and vegetables that inhabited the region of Uberaba millions of years ago. It is installed in the building of the old railway station of Peirópolis, built in 1889, in English style.

Visiting hours: Tuesday to Friday from 08 to 17h and Saturday, Sunday and holidays from 08h to 18h.

In the period of January (holidays) the Museum is also open on Mondays. During the Carnival period it will only close on February 10.

BR 262, km 784, Bairro de Peirópolis.

(34) 3338-1526.

Link ............ www.uberaba.mg.gov.br/portal/conteudo,706

Amblyteles armatorius - female by markhortonphotography

This ichneumon wasp we found wandering across the kitchen floor should really be tucked away somewhere safe this time of year. She'd clearly been disturbed from her over-wintering spot, and spent a while cleaning herself, using a spur on her fore legs to preen her antenna by pulling it through a notch in the tibia covered in hairs.

Te regalo un paraíso, by Memo Vasquez

3 45

mis brazos de agua tibia y mi corazón de manzana prohibida.

"Basket Case" Bumble Bees Pollen Baskets. by MontImageMedia

33 14

The pollen basket or corbicula is part of the tibia on the hind legs of the four related lineages of apid bees that used to compose the family Apidae: the honey bees, bumblebees, stingless bees, and orchid bees.The corbicula ("little basket") is a polished cavity surrounded by a fringe of hairs, into which the pollen is placed; most other bees possess a structure called the scopa, which is similar in function, but is a dense mass of branched hairs into which pollen is pressed, with pollen grains held in place in the narrow spaces between the hairs. A honey bee moistens the forelegs with its protruding tongue and brushes the pollen that has collected on its head, body and forward appendages to the hind legs. The pollen is transferred to the pollen comb on the hind legs and then combed, pressed, compacted, and transferred to the corbicula on the outside surface of the tibia of the hind legs. A single hair functions as a pin that secures the middle of the pollen load. Honey and/or nectar is used to moisten the dry pollen, producing the product known as bee pollen or bee bread. The mixing of the pollen with nectar or honey changes the color of the pollen. The color of the pollen can identify the pollen source.

Halictus confusus, m, back, Prince George's Co., MD_2017-06-09-13.09 by USGS Bee Lab

4 1

Once of our dirtball species. Common, found almost everywhere including people's gardens and in our agricultural fields. This is group (Halictus) if often identifiable in the males by the the dark spot/section on the outer face of the hind tibia. If you don't key in on that they are often misidentified as Lasioglossum species, which have many species that have the dark metallic green feel your see here. Collected in Prince George's County (possibily in my garden) and photographed by Sydney Price.

~~~~~~~~~~{{{{{{0}}}}}}~~~~~~~~~~

All photographs are public domain, feel free to download and use as you wish.

Photography Information: Canon Mark II 5D, Zerene Stacker, Stackshot Sled, 65mm Canon MP-E 1-5X macro lens, Twin Macro Flash in Styrofoam Cooler, F5.0, ISO 100, Shutter Speed 200

Beauty is truth, truth beauty - that is all

Ye know on earth and all ye need to know

" Ode on a Grecian Urn"

John Keats

You can also follow us on Instagram - account = USGSBIML Want some Useful Links to the Techniques We Use? Well now here you go Citizen:

Free Field Guide to Bee Genera of Marylandhttp://bio2.elmira.edu/fieldbio/beesofmarylandbookversion1.pdf

Basic USGSBIML set up:

www.youtube.com/watch?v=S-_yvIsucOY

USGSBIML Photoshopping Technique: Note that we now have added using the burn tool at 50% opacity set to shadows to clean up the halos that bleed into the black background from "hot" color sections of the picture.

www.youtube.com/watch?v=Bdmx_8zqvN4

Bees of Maryland Organized by Taxa with information on each Genus

www.flickr.com/photos/usgsbiml/collections

PDF of Basic USGSBIML Photography Set Up:

ftp://ftpext.usgs.gov/pub/er/md/laurel/Droege/How%20to%20Take%20MacroPhotographs%20of%20Insects%20BIML%20Lab2.pdf

Google Hangout Demonstration of Techniques:

plus.google.com/events/c5569losvskrv2nu606ltof8odo

www.youtube.com/watch?v=4c15neFttoU

Excellent Technical Form on Stacking:

www.photomacrography.net/

Contact information:

Sam Droege

sdroege@usgs.gov

301 497 5840

SGT. Tibias Anderson. by Dal Lee

9 6

Leader of the Echo Company.

PROTECTOR TIBIA CONFORT by DAEDO COLOMBIA

Tipo Confort

REFERENCIA PRO 1571

Tallas S-M-L-XL

Contáctenos:

WhatsApp 310 583 46 07

TELÉFONO FIJO (+ 57 1) 311 5468

Ventas Online

ventas@daedocolombia.com

Bogotá - Colombia

Bones of the leg by University of Liverpool Faculty of Health & Life Sciences

Detail from plate 6, engraved anatomical illustration of the "jonctures and articulations of the arm and leg - articulation of ye thigh-bone with ye tibia" from: Anatomy improv'd and illustrated with regard to the uses thereof in designing. (London: John Senex, 1723).

This volume of engraved plates and text was originally published in Rome in 1691, and was re-engraved and republished in London in 1723. The dissections were done for the Italian edition by Bernardino Genga, Professor of Anatomy and Surgery and physician in the hospital of San Spirito in Rome, and the explanatory text by the papal physician Giovanni Maria Lancisi (1654-1720). The book, designed for artists rather than medical students, includes plates of famous classical statues from Rome and is described as 'A work of great use to painters, sculptors, statuaries and all others studious in the noble arts of design'.

The English edition is dedicated by the publisher to Richard Mead, FRCP, FRS (1673-1754), 'a favourer of the politer arts'.

Part of the Anatomical Atlases in Special Collections & Archives, SPEC Anatomy 6. Cropped inscription on the titlepage, 'Tho. Dixon's Book 1799' and the pencilled name' Miss Annie Jackson, 19 North Street' on the front flyleaf, with pencil measurements possibly from a dissected skeleton on the back of the last (index) page.

The volume has had some plates cut out, but has also been grangerised with later anatomical illustrations pasted in.

Images from Medical books in Special Collections at University of Liverpool

Scientist, Commander and the Mi6 agent. by Dal Lee

3 1

Doctor Sidney Sanders, Commander Jake Rivers, and MI6 agent Tibias.

2154 Cabbage Moth (showing hairy eyes and the spur on the foreleg tibia) by Paul Kitchener

4 2

Ipswich, Suffolk, 6 May 2017

Posterior leg, superficial view by emmanuelsegmen

Leon & Mr. Tibias by Dal Lee

11 1

Is Mr. Tibias trying to lure away Leon to join MI6?

Bones of the leg by University of Liverpool Faculty of Health & Life Sciences

Plate 8 showing engraving of the bones of the leg from: Anatomy improv'd and illustrated with regard to the uses thereof in designing. (London: John Senex, 1723).

The English edition is dedicated by the publisher to Richard Mead, FRCP, FRS (1673-1754), 'a favourer of the politer arts'.

The volume has had some plates cut out, but has also been grangerised with later anatomical illustrations pasted in.

Medical Education

Image of bones/skeleton of leg

Tibia 7.6 by Bruno Geraldi

3 1

Tibia 7.6

Alrighty...so, Friday night, I fell into a hole (it was lurking in some grass I was walking in & the grass had grown over it...just didn't see it & stepped right in) and as a result, I broke my left leg (tibia AND fibula) and ankle. After visiting an ort by Alex Emsley

Mitch Milan tiger shark attacked surfboard by Brian Howell

2 11

Shark attack at Davidson's surf break in Kekaha, Kauai.

It happened after sunset on Oct. 9th, 2017.

According to the so-called "experts", there have "only" been TEN FATAL shark attacks in Hawaii since 1980. Here's a list of those fatal attacks. (note asterisk * indicates fatal attack confirmed by so-called experts).

5/24/81 - Roger Garletts - Haena, Kauai - Scuba diving

4/20/86 - Levi Chandler - Kalihiwai Point, Kauai - shore fishing

4/15/87 - Daniel Kennedy - Kailua-Kona - swimming

4/15/88 - Avery Goo - Powerboat overturned, Waihe'e, Maui

1/8/89 - Ken Ahlstrand - Wailua, Kauai - swimming with 3 others when he disappeared. Lower part of body found 6 days later, x-rays revealed teeth marks in femur & tibia

10/14/89 - Ray Mehl - Kahe point, Oahu - scuba diving

2/17/90 - Roy Tanaka - Mokapu, Kaneohe Marine Base - scuba spearfishing

11/19/91 - Suk Kyu (Steve) Park - Maliko Point, Maui - washed into ocean while shore fishing

11/26/91 - Martha Morrell - Olowalu, Maui - swimming *

2/19/92 - Bryan Adona - Leftovers, near Waimea Bay, Oahu - body boarding

11/4/92 - Aaron Romento - Keaau Beach Park, Oahu - body boarding

12/1/93 - Daniel McMoyler - Waipio, Hawaii - surfing

1/31/94 - Jim Broach - Velzyland - surfing - body parts seen but not recovered.

4/28/96 - Wayne Leong - Lobster diving lost near Laie Point, Oahu. Wetsuit remnants showed evidence of attack by large tiger shark.

7/14/96 - Trimurti Day - disappeared while jumping off rocks after midnight at Nakalele Point, Maui. Shark bitten remains found later.

3/18/1999 - Nahid Davoodabai - offshore south-east Maui - kayaking

4/4/04 - Courtney Marcher - Velzyland - surfing

4/7/04 - William McInnis - Kahana, Maui - surfing *

2/23/06 - Anthony Moore - Makena, Maui - free diving

8/30/08 - Kameron Brown - McKenzie Beach Park , Pahoa - cliff jumping / swimming (Great White Shark)

4/11/09 - Paolo Dominici - Kona - spearfishing

8/14/13 - Jana Lutteropp - Makena, Maui - snorkeling *

12/2/13 - Patrick Briney - offshore Makena, Maui - kayak fishing *

4/29/15 - Margaret Cruse - Kanahena cove / Ahihi, Makena, Maui - snorkeling *

9/17/15 - Loren "Jamie" Salis - Upolu Point - night spearfishing

10/14/16 - Joshua Goodwin - Hana, Maui - missing while spearfishing

5/25/2019 - Dr. Thomas Smiley - Kaanapali Shores, Maui, tourist swimming*

6/23/2019 - Vladimir Sukhoparov 58, of Cincinnati Ohio goes missing while swimming offshore Wailua beach, Kauai. East swell was minimal and waters were calm but very murky due to several days of rain. A helicopter searched exhaustively for 3-days before search was called off. The guy looked fit for his age. No mention of shark in news, but c'mon, it doesn't take a rocket scientist to realize what likely occurred.

7/23/19 - Fathi Twalib 34, Queens Pond area of Polihale beach Kauai. Entered ocean at 7:30 P.M. and disappeared after ducking under a small wave near shore. Next morning a very large tiger shark was filmed by drone swimming just 30 yards offshore beach in line with missing man's truck.

10/4/2019 - Alan Delatorre 45, Kailua-Kona, failed to return from a night spear fishing venture. Hawaiʻi Fire Department divers recovered clothes and diving equipment in the waters near the buoy that were identified as belonging to Delatorre. They indicated the damage to the clothing to be attributed to sharks.

7/31/2020 - William "Scott" Stanga, 52, of Hana, Maui disappeared while spearfishing alone at Ku'au Bay beach below Mama's Fish House in Paia during the late afternoon.

12/8/2020 - surfer Robin Warren 56, Honolua Bay, Maui. 17-inch wide bite taken out of surfboard also made severe wound to his left side buttock and upper thigh. Victim was listed as stable after surgery but died the next day.*

6/20/2021 - Nelson Kupenes, 47, disappeared while spearfishing alone during the late afternoon / evening at Glass beach near 'Ele'ele, Kauai. KFD rescue divers recovered his dive float, weight belt, and two spear guns just 25-30 yards offshore. I heard that some body parts were also recovered but that was not in the news reports.

9/14/2021 - 67 year old woman from California disappeared while snorkeling on a dive tour at Molokini Islet offshore of south Maui. The conditions were choppy but she vanished without anyone seeing what happened. All the tour boats present searched for her as did the Coast Guard.

12/14/2021 - Tourist man from Wisconsin age 62, last seen swimming off south point at Chang's Beach fronting Makena Surf Resort. Rescue divers had to quickly exit search area when a large tiger shark appeared. The swimmer's dive mask, snorkel, and one swim fin were subsequently found.

3/7/2022 - Huy Nguyen, 44, disappeared at dusk (7 PM) at Rock Quarry Beach in Kilauea, Kauai. The U.S. Coast Guard said Nguyen had been surfing before handing off his board to his son, saying he was going to swim to shore. A dead humpback whale had washed into the shallow reef area just off the beach prior (Dec. 2021) at the surf spot Pila'a which is just a half mile from Rock Quarry. An oil slick has been visible from atop Pila'a cliff ever since.

12/8/2022 - Kristine Allen from Bellingham, Washington State, 60, was snorkeling 50-75 yards offshore Keawakapu beach in Kihei with her husband Blake when they encountered a large tiger shark. Reportedly he fought off the shark as it made several passes. He managed to swim ashore but his wife vanished during the incident and was never seen again. Her mask & snorkel were recovered where she was last seen. One report mentioned that a piece of her blue bathing suit washed ashore. A 10-12 foot tiger shark was observed in the same area the following morning. *

12/30/2023 - Jason Carter age 39 of Haiku, Maui died of injuries sustained in a shark attack while surfing at Pa'ia Bay on the north-east side of the island. *

06/23/2024 - Tamayo Perry, renown Pipeline surfer and C&C Honolulu Lifeguard is killed likely by a tiger shark while surfing at Goat Island, Malaekahana on Oahu's east side. He sustained multiple bites and lost an arm and a leg. *

9/23/2025 - Bryson Higashi, 44, last seen solo spearfishing at Waikoko's in Hanalei Bay. Shredded camouflage blue diver wetsuit material discovered washed ashore a couple days after.

1/28/2026 - Matthew Kaimana Packard-Asai, 19, of Kapaa - swept into the ocean while shore fishing along rocky coastline at Kahili beach / Rock Quarry in Kilauea. Female companion was also swept into the ocean and suffered a laceration to her leg. She was rescued shortly thereafter but Matthew Kaimana Packard-Asai disappeared from view. On Saturday January 31, 2026 his shark devoured remains were found in the vicinity.

These 41 fatalities may not have had the multiple eye-witnesses that the eight "expert-confirmed" attacks did, but it doesn't take a rocket scientist to understand what a shark chewed and regurgitated wetsuit or surf shorts implies. Nor does drowning in a tiger shark's jaws as it takes a victim underwater invalidate the fact that death and subsequent consumption was due to a shark attack (ie. Anthony Moore at Makena, Maui 2006). Likewise, does anyone really think Bryan Adona (whose body was never found) died from some other cause when a large tiger shark was seen within a few yards of where he was when he went missing and a huge shark bite taken out of his body-board was subsequently discovered?

* indicates fatal attack confirmed by so-called experts

wizardofbaum.blogspot.com/2011/05/history-of-reported-fat...

Tibia-tarzo quebrado6 by Jaime Robles

SONY DSC

The final outcome of @brendan_66 's skating accident. 6 breaks over both tibia and fibula. by Manuel Sanvictores

Curso de Estética y Salud EYS64M2019 by Formaemplean

Clase de depilación con cera tibia

Bath and England rugby star Olly Barkley receiving physio by Exogen

Olly Barkley has been using EXOGEN to aid his recovery from a fractured tibia and fibula sustained in March 2011.

Please refer to our “Profile” tab for indications for use and risk information for EXOGEN.

Distal Tibia by John Rochester

Fallow deer 7-8 months

broken fibula and tibia. got mowed down by a motocross bike that was coming up the mountain bike trail i was riding down. No heels for me for a while 😂😂😂 by Amy Cooper

the dogs broke my leg! by Heather Lucille

2 2

take a good look kids - it's my freshly broken leg. it's nice and puffy and boy does it hurt!

two labs pwned me and busted my leg at the dog park last night.

Gidget's X-ray by Eldad Hagar

2 3

and again, broken Tibia & broken Fibula...

Dr. Erin Wilson will fix Gidget's leg tomorrow, and she should be back on her feet pretty soon.

Eldad

This image is taken from United States Naval Medical Bulletin Vol. 15, Nos. 1-4, 1921 by Medical Heritage Library, Inc.

Go to the Book with image in the Internet Archive

Title: United States Naval Medical Bulletin Vol. 15, Nos. 1-4, 1921

Creator: U.S. Navy. Bureau of Medicine and Surgery

Publisher:

Sponsor:

Contributor:

Date: 1921

Language: eng

Table of Contents

Number 1

PORTRAIT OF SURGEON GENERAL E. R. STITT, U. S. NAVY —Frontispiece

PREFACE vii

NOTICE TO SERVICE CONTRIBUTORS vii

THE NAVAL HOSPITAL, MARE ISLAND, CALIF. :

HISTORY OF THE HOSPITAL.

By Captain A. Farenholt, Medical Corps, U. S. N 1

Operating room technique.

By Lieutenant Commander Lucius W. Johnson, Medical Corps, and Bessie C.

Graham, Nurse Corps, U. S. N 10

The urological service.

By Lieutenant Commander A. B. Hepler, Medical Corps, U. S. N__ 16

The roentgenological service.

By Lieutenant H. R. Coleman, Medical Corps, U. S. N 30

The laboratory.

By Lieutenant G. A. Gray, Medical Corps. U. S. N 34

Features of organization.

By Commander E. C. White, Medical Corps, U. S. N 40

General file and record system.

By Lieutenant D. C. Allen, Medical Corps, U. S. N 4T

Suggested clinical chart.

By Lieutenant Commander M. C. Baker, Medical Corps, U. S. N 49

The theater.

By Chief Pharmacist T. C. Hart, Medical Corps, U. S. N 50

Study of one hundred navy desertions.

By Lieutenant A H. Ehrenclou. Medical Corps, U. S. N., and

Lieutenant W. H. Wilson, Chaplain Corps, U. S. N. R. F 53

Surgical failures.

By Lieutenant Commander Lucius W. Johnson, Medical Corps,

U. S. N 69

Circumcision.

By Lieutenant Commander Lucius W. Johnson, Medical Corps, U. S. N 77

A glue cast for fractures of long bones.

By Lieutenant H. R. Coleman, Medical Corps, U. S. N . 79

Tuberculin in the early diagnosis of tuberculosis.

By Lieutenant G. A. Gray, Medical Corps, U. S. N 81

Diphtheria at Mare Island, Calif., in 1920.

By Lieutenant G. A. Gray, Medical Corps, U. S. N 84

Agglutination of human erythrocytes by sera.

By Lieutenant G. A. Gray, Medical Corps, U. S. N., and Pharmacist's

Mate E. C. Upp, U. S. N 8G

A method of ringing the hanging drop, etc.

By Hospital Apprentice First Class D. G. Willard, U. S. N 92

Preparation of colloidal gold solution.

By Marie Karlen. Reserve Nurse Corps, and Pharmacist's Mate First Class

A. E. Bourke, U. S. N 94

Report of seventy-five refraction cases.

By Lieutenant W. D. Horner, Medical Corps, U. S. N 95

Empyema cases.

By Lieutenant E. R. Guinan, Medical Corps, U. S. N 99

Acute mastoiditis. Page.

By Lieutenant C. N. Meador, Medical Corps, U. S. N 106

Dental foci in the etiology of systemic disease.

By Lieutenant A. H. Ehrenclou, Medical Corps, and Lieutenant

B. F. Loveall, Dental Corps, U. S. N 109

Transfusion in medical cases.

By Lieutenant D. H. Murray, Medical Corps, TJ. S. N 117

A DENTAL BRANCH OF THE HOSPITAL COBPS.

By Lieutenant B. F. Loveall, Dental Corps, U. S. N 118

A CASE OF TUBERCULOUS PEBICABDITI8.

By Lieutenant A. H. Ehrenclou, Medical Corps, U. S. N 120

A CASE OF ACUTE ANILINE POISONING.

By Lieutenant A. H. Ehrenclou, Medical Corps, U. S. N 123

A CASE OF TUBERCULOUS MENINGITIS.

By Lieutenant J. J. Sale, Medical Corps, U. S. N 126

A CASE OF NEUROPARALYTIC KERATITIS.

By Lieutenant C. N. Meador, Medical Corps, U. S. N 127

Vernal conjunctivitis treated with radium.

By Lieutenant W. D. Horner, Medical Corps, U. S. N 1 128

A case of acute myelitis.

By Lieutenant L. E. Smith, Medical Corps, U. S. N 130

A case of osteoma of the tibia.

By Lieutenant F. G. Linde, Medical Corps, U. S. N 131

A DISLOCATED SEMILUNAR CARTHAGE.

By Lieutenant F. G. Linde, Medical Corps, U. S. N 132

A CASE OF COMPOUND FRACTURE OF TIBIA AND FIBULA.

By Lieutenant F. G. Linde, Medical Corps, U. S. N 132

A DEATH FROM NITRIC ACID POISONING.

By Lieutenant G. A. Gray, Medical Corps, U.S. N 133

NECROSIS OF THE MANDIBLE ; TWO CASES.

By Lieutenant B. F. Loveall, Dental Corps, U. S. N 134

HISTORICAL.

Alexis Soyer.

By Captain J. S. Taylor, Medical Corps, U. S. N 139

EDITORIAL.

Morale 175

SPECIAL ARTICLES.

Venereal statistics of the Army and Navy: A study of certain published

reports.

By Captain C. E. RIggs. Medical Corps, U. S. N 179

Report of one hundred compound fractures due to shell fragments or

machine-gun bullets.

By Lieutenant Commander A. L. Clifton, Medical Corps, U. S. N__ 191

A Death From Novarsenobenzol.

By Lieutenant Commander R. A. Torrance, Medical Corps, U. S. N 193

Mercurochrome —220, in dentistry.

By Lieutenant Commander W. L. Darnall, Dental Corps, U. S. N_ 194

PROGRESS IN MEDICAL SCIENCES.

General medicine. —Diagnosis and treatment of pulmonary tuberculosis.

—The clinical recognition of syphilis. —Mercury bichloride Intravenously. —

Transduodenal lavage. — Immunization against diphtheria. —Buccal auscultation

197

Mental and nervous diseases. — Malingering. —Extending the field of

conscious control. —The patient himself. —Anxiety and fear 210

Surgery. —Blood transfusion. —Dangers of transfusion. —Mixture of ethyl

chloride, chloroform, and ether for anesthesia. — Skin grafting.—Autoplasties

for baldness. —Bladder tumors 217

Hygiene and sanitation. —Hospital tires.—Coffee and vitamines 223

Tropical medicine. —Sterilization of ova in bilharziasis.—Antimony in the

treatment of bilharziasis 226

Eye, ear, nose, and throat. —Cause and diagnosis of glaucoma ; treatment

by myotics.— Corneal disease of tubercular origin. —Action of chloral on the

pupil 227

NOTES AND COMMENTS.

Enlistments. —Professional training of experienced officers.—The case of

the U. S. S. Pittsburgh. —Prostatic lithiasis.—Cessation of respiration 15

hours before death. —Chloropierin to exterminate rats. —The Annual Report of

the Surgeon General, U. S. Navy. —Finding malarial parasites.— Icterus in

malaria.—Excretion of quinine.— Student health at the University of

Iowa.—Conference on war victims. —Pleasure and profit in the Medical Corps of

the Navy. —Law regarding thermometers. —Adhesive plaster. —The essential in

nursing. —Laxative cookies.—Samoa. —The Navy Mutual Aid Association 236

BOOK NOTICES 251

Number 2

PREFACE VII

NOTICE TO SERVICE CONTRIBUTORS VIII

SPECIAL ARTICLES:

Treatment of influenza.

By Commander J. L. Neilson, Medical Corps, U. S. N 269

Intravenous use of magnesium sulphate in influenzal pneumonia.

By Lieutenant J. J. Hogan, Medical Corps, U. S. N. R.F. 277

Accidental injuries from electric currents.

By Commander W. J. Zalesky and Lieutenant W. T. Brown, Medical Corps,

U. S. N 279

Methods of sterilization in dentistry.

By Lieutenant Commander H. E. Harvey, Dental Corps, U. S. N. 282

Peptic ulcer.

By Lieutenant C. S. Norburn, Medical Corps, U. S. N 285

SURVEY OF FIFTY COURT-MARTIAL PRISONERS.

By Lieutenant C. H. Castle, Medical Corps, U. S. N. R.F 291

Hospital training of apprentices.

By Lieutenant A. H. Ehrenclou, Medical Corps, U. S. N 296

Methods of instructing hospital corpsmen.

By Lieutenant Commander W. M. Kerr. Medical Corps, U. S.N 302

Standardizing treatment for venereal disease.

By Lieutenant Commander W. D. Owens, Medical Corps, U. S. N 308

Plan of organization for a naval hospital.

By Captain R. P. Crandall and Commander W. A. Angwin, Medical Corps, U.

S. N 316

HISTORICAL:

SURGERY IN THE MIDDLE AGES.

By Captain J. S. Taylor, Medical Corps, U. S.N 347

EDITORIAL:

Calling a spade an implement of horticultural utility 377

"To bide the hobbyhorse with the boys " 378

SIGGESTED DEVICES:

RETINOSCOPIC LENS HOLDER.

By Captain J. S. Taylor, Medical Corps, U. S. N 383

Strong room for alcohol and narcotics.

By Captain A. Farenholt, Medical Corps, U. S. N 385

Detection of mosquito larvae.

By Lieutenant Commander J. C. Parham, Medical Corps, U. S. N 380

CLINICAL NOTES:

Tuberculous meningitis simulating lethargic encephalitis.

By Lieutenant Commander W. A. Bloedorn, Medical Corps, U. S. N 387

Advancement of ocular muscles by the Fox technique.

By Lieutenant Commander C. B. Camerer, Medical Corps. U.S. N 392

Surgical treatment of "saddle nose" deformity.

By Lieutenant Commander C. B. Camerer, Medical Corps. U. S. N 397

A HAND PLASTIC.

By Lieutenant Commander Lucius W. Johnson. Medical Corps, U. S. N 399

Dislocation of first cervical vertebra.

By Captain G. T. Smith, Medical Corps, U. S. N 400

Death from neo-arsphenamine.

By Commander W. .T. Za leaky and Lieutenant J. B. Bellinger, Medical Corps,

U. S. N 401

Thrombosis of the lateral sinus.

By Lieutenant Commander E. E. Koebbe, Medical Corps, U. S. N_ 403

Orchitis complicating tonsillitis.

By Lieutenants J. D. Benjamin and T. C. Quirk, Medical Corps, U. S. N 408

Operations for trauma of the urethra.

By Lieutenant W. L. Cowles, Medical Corps, U. S. N. R. P 407

Sea sickness.

By Commander C. E. Henry. Medical Corps, U. S. N. R. F 410

Treatment of the " West Indian chancroid."

By Lieutenant Commander W. H. Michael, Medical Corps, U. S. N 412

PROGRESS IN MEDICAL SCIENCES:

General medicine. —The arsphenaniines in therapeutics. —Recital absorption

of glucose 415

Mental and nervous diseases. —lethargic encephalitis. —Theory of hysteria.

—Mental deficiency 420

Surgery. —Resuscitation in death under anesthesia. —Advances in anesthesia.

— Sloughing in local anesthesia. —Anesthesia in abdominal surgery. —

Suppurating wounds after abdominal section. —Saving suppurating Incisions.

—Abdominal adhesions. —Perforating gastric and duodenal ulcer. — Persistence of

pyloric and duodenal ulcers. — Diverticula of the duodenum.— Orthopedic

treatment of burns. —Postoperative bronchial irritation. —Care of surgical patients.

—End-to-end anastomosis. —Genital tuberculosis.— Radium therapy of cancer of

bladder. — Radium and malignant genitourinary disease.—Bone tumors. —Fracture

of vertebrae. —Penetrating wounds of chest. —Operation for empyema.—Plastic war

surgery in civil life. —The war's contribution to civil surgery 429

Hygiene and sanitation. —Typhus fever in Serbia 455

Pathology, bactkriology, and animal parasitology. —Diagnosis of cholera.

—Staining malarial parasites. —Saprophytysm of venereal organisms. — Variation

in size of red cells. —Anophellnes of California. —Reaction from echinococcus fluid

457

Eye, ear, nose, and throat.— Encephalitis lethargica 487

NOTES AND COMMENTS:

Bronchospirochaetosis. — Starvation edema. —Dried cabbage as an antiscorbutic.

—Miner's nystagmus. —Endocrines and the teeth. — Orientation of bats. — Sugar

production.- -The teeth of the ancient Egyptians. —Treatment of enlarged

thymus. —Plague in Paris.— Antivenereal campaign in Rouen.— Medical school of

the University of Virginia. —Postgraduate study In the Japanese Navy. — National

Academy of Science.—Peking Unjon Medical College. — The dye Industry. — Naval

medical service as a career. —Naval dispensary and hospital defined.— Death of

Anton Weichselbaum. — Action of the Women's Civic League, Maiden, Mass. — Dr.

Russel H. Boggs. — Preservation of leather. —Service publications. —Picric acid

469

REPORTS :

Sewage system in Charlotte Amalia.

By Lieutenant R. L. Pettigrew, Civil Engineer Corps, U. S. N. and

Lieutenant E. Peterson. Medical Corps, U. S. N 481

Application of the Schick reaction to 2,011 naval recruits.

By Lieutenant B. F. Norwood. Medical Corps, U. S. N 486

Smallpox in Haiti.

By Lieutenant Commander K. C. Melborn, Medical Corps, U. S. N 492

Sanitary report on Libau, Latvia.

By Lieutenant Commander A. C. Smith and Lieutenant R. P. Parsons,

Medical Corps, U. S. N 492

Summer school, Hampton Roads, Va.

By Lieutenant Commander K. E. Lowman, Medical Corps, U. S. N 495

INFORMATION WANTED 498

BOOK NOTICES 499

Number 3

NOTICE TO SERVICE CONTRIBUTORS VI

CLINICAL NOTES : Surgical service of the United States Naval Hospital,

New Orleans, La.

By Lieutenant Commander W. J. Riddick and Lieutenant Commander E. A.

Stephens, Medical Corps, U. S.N. 507

A CASE OF HYSTERIA IN THE NAVAL SERVICE.

By Lieutenant Commander W. A. Bloedorn, Medical Corps, U. S. N. 515

A CASE OF HYSTERICAL CONTRACTURE.

By Lieutenant A. H. Ehrenclou, Medical Corps, U. S. N 521

X-RAY PROCEDURE AND TECHNIQUE.

By Lieutenant Commander I. E. Jacobs, Medical Corps, and Chief

Pharmacist's Mate C. B. Worster, U. S. N 524

Interpretation of abdominal rigidity.

By Lieutenant Commander Lucius W. Johnson, Medical Corps, U. S. N 529

A CASE OF ECHINOCOCCUS CYST.

By Lieutenant C. S. Norburn, Medical Corps, U. S. N 530

NONCORRODIBLE INSTRUMENTS.

By Lieutenant Commander G. C. Thomas, Medical Corps, U. S. N 532

Aseptic technique for canal instruments.

By Lieutenant Commander H. E. Harvey, Dental Corps, U. S. N 533

Traumata due to falling.

By Lieutenant Commander H. H. Lane, Medical Corps, U. S. N 535

Administration of neosalvarsan.

By Lieutenant J. B. Bostick, Medical Corps, U. S. N 536

Diet deficiency in Vincent's angina.

By Lieutenant C. H. Morris, Dental Corps, U. S. N 540

Vincent's infection of the -mouth.

By Lieutenant (j. g.) J. B. Goodall, Dental Corps, U. S. N. R. F 542

Penetrating wound of the pelvis.

By Lieutenant F. P. Gardner, Medical Corps, U. S. N 544

Traumatic rupture of spleen —removal.

By Lieutenant Commander F. H. Bowman, Medical Corps, U.S. N., and

Lieutenant Commander E. M. Foote, Medical Corps, U. S. N. R. F 545

Operation for wrist drop.

By Lieutenant J. I. Yohannan, Medical Corps, U. S. N 547

A PLASTIC OPERATION ON THE MUSCLES OF THE SHOULDER.

By Lieutenant R. W. Auerbach, Medical Corps, U. S. N 54S

A SIMPLE OPERATION FOR TRICHIASIS.

By Lieutenant H. S. Cragin, Medical Corps, U. S. N. R. F 551

A CASE OF ADENO-CARCINOMA.

By Lieutenant Commander M. Boland, Medical Corps, U. S. N— 552

Chancroidal infections.

By Lieutenant W. F. Pearce, Medical Corps, U. S. N 554

A CA8E OF INNOCENT SYPHILIS.

By Lieutenant J. W. Jones, Medical Corps, U. S. N 556

A CASE OF CARCINOMA OF THE TESTICLE.

By Lieutenant W. J. Corcoran, Medical Corps, U. S. N 557

Removal of an unusually large tumor.

By Commander E. L. Jones, Medical Corps, U. S. N 558

HISTORICAL:

A RETROSPECT OF NAVAL AND MILITARY MEDICINE.

By Captain J. S. Taylor, Medical Corps, U. S. N 561

EDITORIAL :

Accidental poisoning — Contributing to the Bulletin —The omission of

the—The future of nursing — Comparative values 627

PROGRESS IN MEDICAL SCIENCES :

General medicine — Mechanism of hiccough — Gases In arterial blood—Treatment

of arsenic poisoning —Treatment of encephalitis letharglca —New test for

nephritis—Blood in pellagra and beri beri —Ocular symptoms in sinus

disease—Reaction from repeated transfusions —Eye symptoms in epidemic

encephalitis —Diagnosis and treatment of hemorrhoids —Cost of venereal

disease—Future of medicine in the United States 637

Mental and nervous diseases —The criminal—Brain lesions of dementia

praecox —Follow-up studies on mental patients 652

Surgery—Trauma of the abdomen— Rubber dam tampon —Diagnosis of gastric

or duodenal ulcers —Postoperative thrombophlebitis — Treatment of fractured

patella —Affections of the tibial tubercle— 655

Hygiene and Sanitation —Sanitary features of merchant ships 659

NOTES AND COMMENTS :

Errata —Centenary of von Helmholtz —Retirement of Filippo Rho, Surgeon

General, Italian Navy—A diagnostic point in tuberculosis —Curing hemorrhoids

—The X-ray and art— Industrial code of New

York —Preservation of eyesight —Basal metabolism —American Society of Tropical

Medicine —Laboratory work in the Far East— Dentistry in South America

—Fireprooflng of fabrics—The exploration of Mount Everest — Physical

development in Japan — Hiccough and encephalitis lethargica —Use of fish as

food in France — Service items 665

REPORTS :

Rat-Proofing at the United States Navy Yard, Key West, Fla.

By Lieutenant Commander P. E. Garrison, Medical Corps, U. S. N 673

Report of the Fifth Congress of the International Society of Surgery,

Paris.

By Lieutenant S. B. Burk, Medical Corps, U. S. N. R. F. (Inactive) 681

Smallpox in Port Au Prince, Haiti.

By Lieutenant C. J. Brown, Medical Corps, U. S. N 695

Medical Department of the United States Naval Torpedo Station,

Alexandria, Va.

By Lieutenant Commander C. C. Kress, Medical Corps, U. S. N 701

The Herman-Perutz Reaction.

By Lieutenant G. V. Genzmer, Medical Corps, U. S. N. R. F 708

BOOK NOTICES 711

Number 4

PREFACE V

NOTICE TO SERVICE CONTRIBUTORS VI

SPECIAL ARTICLES :

Color blindness.

By Captain E. J. Grow, Medical Corps, U. S. N 717

Cardiac irregularity.

By Commander E. U. Reed, Medical Corps, U. S. N 732

Handling of recruits, Marine Barracks, Parris Island.

By Lieutenant Commander J. C. Parham, Medical Corps, U. S. N 740

Four centuries in the treatment of syphilis.

By Lieutenant L. W. Shaffer, Medical Corps, U. S. N 749

A Marine Corps field hospital.

By Lieutenant Commander G. F. Cottle, Medical Corps, U. S. N 762

Training and care of the football squad, U. S. Naval Academy, Annapolis,

Md.

By Lieutenant M. H. Roberts, Medical Corps, U. S. N. R. F 770

Gas poisoning in warfare.

By Lieutenant G. H. Mankin, Medical Corps, U. S. N 775

Venereal prophylaxis among U. S. Marines at Honolulu.

By Lieutenant Commander H. H. Lane, Medical Corps, U. S. N_. 783

HISTORICAL :

The Manila Galleon.

By Lieutenant Commander W. M. Kerr, Medical Corps, U. S. N. 787

EDITORIAL :

On learning to write-—On several phases of syphilis 801

SUGGESTED DEVICES :

Dental X-ray film holder.

By Lieutenant Commander H. E. Harvey, Dental Corps. U. S. N_- 807

Suggestion for recording dental conditions.

By Lieutenant Commander H. E. Harvey, Dental Corps, U. S. N-- 807

CLINICAL NOTES :

A CASE OF CUTANEOUS SPOROTRICHOSIS.

By Commander R. E. Hoyt, Medical Corps, U. S. N 809

Report of pellagra in Haiti.

By Lieutenant Commander G. F. Clark, Medical Corps, U. S. N__ 813

Acute rheumatic fever.

By Lieutenant W. M. Alberty, Medical Corps, U. S. N 814

A case of poisoning by oil of chenopodium.

By Lieutenant B. F. Norwood, Medical Corps, U. S. N 818

Brushing the teeth.

By Lieutenant Commander H. E. Harvey, Dental Corps, U. S. N 824

TWENTY-EIGHT CASES OF PNEUMONIA.

By Lieutenant J. R. Jeffrey, Medical Corps, U. S. N 825

A CASE OF TUBERCULOUS MENINGITIS.

By Lieutenant Commander S. P. Taylor, Medical Corps, U. S. N— 830

Cholecystectomy and pyelotomy in

Guam.

By Commander A. H. Robnett, Medical Corps, U. S. N 831

Elephantiasis of the scrotum.

By Lieutenant L. W. Breene, Medical Corps, U. S. N., and W. Zur Linden,

chief pharmacist, Medical Corps, U. S. N 884

Rules for massage.

By Commander W. S. Bainbridge, Medical Corps, U. S. N. R. F— 835

PROGRESS IN MEDICAL SCIENCES :

General medicine. —Transfusion of blood—Diabetes mellitus In the Negro

race— Diagnosis of syphilis In malarial subjects —So-called diseases of the

blood— Singultus— The role of the prostate and

seminal vesicles in arthritis —Medical aspects of naval aviation — Treating

syphilitics—The etiology of scurvy —Food accessory factors in relation to the

teeth 839

Surgery. —Immediate surgery in fighting ships —Immediate surgery of war

wounds as practiced in hospital ships —The surgical treatment of empyema by a

closed method—Willems treatment of

knee-joint injuries —Observations on primary venereal sores—Resection

of the small intestine for war wounds —Tetanus in the British Army during the

European War 855

Tropical medicine. —New method of treatment of trypanosomiasis — Differential

diagnosis in tropical fevers —Schistosomiasis in the Yangtse Valley—Carriers of

dysenteriae among soldiers —Liverpool School of Tropical Medicine 870

Pathology, bacteriology, and animal parasitology. — Cultivation of gonococcus—Aestivo-autumnal

malaria Plasmodia —Virulence of diphtheria-like organisms 885

Chemistry and pharmacy.—Absorption of calcium salts in man— Improvements

in the Nephelometer-Colorimeter — Substitution of turbidimetry for nephelometry

in certain biochemical methods of analysis— Creatinuria —Phosphoric acid in the

blood of normal infants—Basal metabolism of normal women—Fat-soluble vitamine— Standards

for normal basal metabolism 887

Eye, ear, nose, and throat.- —Injuries to the ear in modern warfare— Injuries

to the ear in modern warfare— Symptomatology and diagnosis of foreign bodies in

the air and food passages—Etiology and prevention of injuries to the eye

—Mosher-Totl operation on the lachrymal sac —-Tuberculosis of the middle ear

892

NOTES AND COMMENTS :

Colles's Fracture—The French view of an American medical congress —Case

Records of the Massachusetts General Hospital— National cancer week- —

Pharmacopoeia of China —Municipal disposal of garbage—American Journal of

Tropical Medicine —Danger of week-end camping in the Tropics — Influenza

epidemic in the British Navy —Benvenuto Cellini—A Consulting Surgeon in the

Near

East—Asphyxiation in Garages —Dental service In the British Navy

—Surgeon Captain Lomas, R. N.—Counsels and Ideals from the Writings of William

Osler —John Keats, apothecary and poet — Life and times of Ambroise

Pare—Treatment of ozena —Lead poisoning in the pottery trade—The International

Journal of Gastro-Enterology— Treatment of malarial fever —Formaldehyde

poisoning — Toxic effects of shaking arsphenamine solution —Peking Union Medical

College —Milk standards 901

BOOK NOTICES 921

INDEX 983

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Doctor Victoria Tibias by Dal Lee

11 3

Another of the scientist's of the Top Secret project, 'Genesis'. Part of the Black knights unit.

Medical Readiness and Training Exercise 15-3 by U.S. Army Southern European Task Force, Africa

Chadian military doctors perform surgery to repair a fractured tibia April 13 at the Military Teaching Hospital in N’Djamena, Chad. The tibia is that of a Chadian soldier who suffered a gunshot wound to the leg, which caused the bone to fracture. Doctors performed an external fixation procedure as a team of U.S. military medical professionals observed. The U.S. team came to Chad to participate in Medical Readiness and Training Exercise 15-3 known as MEDRETE 15-3. The exercise is a joint effort between the Chadian government, U.S. Army Africa, the Army Reserve Medical Command and the 7th Civil Support Command. MEDRETE 15-3 serves as an opportunity for U.S. and Chadian forces to hone and strengthen their life saving skills as well as reinforce the partnership between both countries. (U.S. Army Africa photo by Staff Sgt. Andrea Merritt)

b>To learn more about U.S. Army Africa visit our official website at www.usaraf.army.mil

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Broken Leg; May 2019 by 7thSon666

Both Tibia and Fibula just below the knee. 3 months in this cast, which went all the way to the hip. Weighed about 5kg of solid plaster. Also meant I had a significant leg length difference, I have about 3cm anyway but this monstrosity took it nearer 5 inches. Could only pivot on it, even with a walking frame, I couldn't move around.

Cambodia - Phnom Penh - Central Market - Grasshoppers - 1 by Manfred Sommer

Grasshoppers are insects of the order Orthoptera, suborder Caelifera. They are sometimes referred to as short-horned grasshoppers to distinguish them from the katydids (bush crickets) which have much longer antennae. They are typically ground-dwelling insects with powerful hind legs which enable them to escape from threats by leaping vigorously. They are hemimetabolous insects (do not undergo complete metamorphosis) which hatch from an egg into a nymph or "hopper" which undergoes five moults, becoming more similar to the adult insect at each developmental stage. At high population densities and under certain environmental conditions, some grasshopper species can change colour and behaviour and form swarms. Under these circumstances they are known as locusts.

Grasshoppers are plant-eaters, sometimes becoming serious pests of cereals, vegetables and pasture, especially when they swarm in their millions as locusts and destroy crops over wide areas. They protect themselves from predators by camouflage; when detected, many species attempt to startle the predator with a brilliantly-coloured wing-flash while jumping and (if adult) launching themselves into the air, usually flying for only a short distance. Other species such as the rainbow grasshopper have warning coloration which deters predators. Grasshoppers are affected by parasites and various diseases, and many predatory creatures feed on both nymphs and adults. The eggs are the subject of attack by parasitoids and predators.

Grasshoppers have had a long relationship with humans. Swarms of locusts have had dramatic effects that have changed the course of history, and even in smaller numbers grasshoppers can be serious pests. They are eaten as food and also feature in art, symbolism and literature.

CHARACTERISTICS

Grasshoppers have the typical insect body plan of head, thorax and abdomen. The head is held vertically, at an angle to the body with the mouth at the bottom. It bears a large pair of compound eyes which give all-round vision, three simple eyes which can detect light and dark and a pair of thread-like antennae which are sensitive to touch and smell. The downward-directed mouthparts are modified for chewing and there are two sensory palps in front of the jaws.

The thorax and abdomen are segmented and have a rigid cuticle made up of overlapping plates composed of chitin. The three fused thoracic segments bear three pairs of legs and two pairs of wings. The forewings, known as tegmina, are narrow and leathery while the hind wings are large and membranous, the veins providing strength. The legs are terminated by claws for gripping. The hind leg is particularly powerful; the femur is robust and has several ridges where different surfaces join and the inner ridges bear stridulatory pegs in some species. The posterior edge of the tibia bears a double row of spines and there are a pair of articulated spurs near its lower end. The interior of the thorax houses the muscles that control the limbs.

The abdomen has eleven segments, the first of which is fused to the thorax and contains the auditory organ and tympanum. Segments two to eight are ring-shaped and joined by flexible membranes. Segments nine to eleven are reduced; segment nine bears a pair of cerci and segments ten and eleven house the reproductive organs. Female grasshoppers are normally larger than males, with short ovipositors. The name "Caelifera" comes from the Latin and means chisel-bearing, referring to the sharp ovipositor.

Those species that make easily heard noises usually do so by rubbing a row of pegs on the hind femurs against the edges of the forewings (stridulation). These sounds are produced mainly by males to attract females, though in some species the females also stridulate.

Grasshoppers are easily confused with the other sub-order of Orthoptera, Ensifera (crickets), but differ in many aspects, such as the number of segments in their antennae and structure of the ovipositor, as well as the location of the tympana and modes of sound production. Ensiferans have antennae that can be much longer than the body and have at least 20–24 segments, while caeliferans have fewer segments in their shorter, stouter antennae.

PHYLOGENY AND EVOLUTION

The phylogeny of the Caelifera based on mitochondrial RNA of 32 taxa in six out of seven superfamilies is shown as a cladogram. The Ensifera, Caelifera and all the superfamilies of grasshoppers except Pamphagoidea appear to be monophyletic.In evolutionary terms, the split between the Caelifera and the Ensifera is no more recent than the Permo-Triassic boundary; the earliest insects that are certainly Caeliferans are in the extinct families Locustopseidae and Locustavidae from the early Triassic. The group diversified during the Triassic and have remained important plant-eaters from that time to now. The first modern families such as the Eumastacidae, Tetrigidae and Tridactylidae appeared in the Cretaceous, though some insects that might belong to the last two of these groups are found in the early Jurassic. Morphological classification is difficult because many taxa have converged towards a common habitat type; recent taxonomists have concentrated on the internal genitalia, especially those of the male. This information is not available from fossil specimens, and the palaentological taxonomy is founded principally on the venation of the hindwings.

DIVERSITY AND RANGE

The Caelifera includes some 2,400 valid genera and about 11,000 species. Many undescribed species probably exist, especially in tropical wet forests. The Caelifera have a predominantly tropical distribution with fewer species known from temperate zones, but most of the superfamilies have representatives worldwide. They are almost exclusively herbivorous and are probably the oldest living group of chewing herbivorous insects.

BIOLOGY

DIET AND DIGESTION

Most grasshoppers are polyphagous, eating vegetation from multiple plant sources, but some are omnivorous and also eat animal tissue and animal faeces. In general their preference is for grasses, including many cereals grown as crops. The mandibles chew the food slightly and salivary glands in the buccal cavity chemically begin to digest the carbohydrates present in it. The food is then passed via the oesophagus to the crop where it is stored temporarily and chemical digestion continues. Next it moves to the gizzard which has muscular walls and tooth-like plates which grind the food. From here, food enters the stomach, where six hepatic caeca add further enzymes and digestion is completed. At the junction between mid and hind-gut, several fine tubes known as malpighian tubules add the excretory products (uric acid, urea and amino acids) to the contents of the gut. Absorption of nutrients takes place in the ileum and any undigested residue is passed on to the colon. Here water is absorbed and the residue becomes solid. After storage in the rectum, the faeces are expelled as small dry pellets.

SENSORY ORGANS

Grasshoppers have a typical insect nervous system,[11] and have an extensive set of external sense organs. On the side of the head are a pair of large compound eyes which give a broad field of vision and can detect movement, shape, colour and distance. There are also three simple eyes (ocelli) on the forehead which can detect light intensity, a pair of antennae containing olfactory (smell) and touch receptors, and mouthparts containing gustatory (taste) receptors. At the front end of the abdomen there is a pair of tympanal organs for sound reception. There are numerous fine hairs covering the whole body that act as mechanoreceptors (touch and wind sensors), and these are most dense on the antennae, the palps (part of the mouth), and on the cerci at the tip of the abdomen. There are special receptors (campaniform sensillae) embedded in the cuticle of the legs that sense pressure and cuticle distortion. There are internal "chordotonal" sense organs specialized to detect position and movement about the joints of the exoskeleton. The receptors convey information to the central nervous system through sensory neurons, and most of these have their cell bodies located in the periphery near the receptor site itself.

CIRCULATION AND RESPIRATION

Like other insects, grasshoppers have an open circulatory system and their body cavities are filled with haemolymph. A heart-like structure pumps the fluid to the head from where it percolates past the tissues and organs on its way back to the abdomen. It circulates nutrients throughout the body and carries metabolic wastes to be excreted into the gut. The haemolymph and the circulatory system are not involved in gaseous exchange. Respiration is performed using tracheae, air-filled tubes, which open at the surfaces of the thorax and abdomen through pairs of valved spiracles. Larger insects may need to actively ventilate their bodies by opening some spiracles while others remain closed, using abdominal muscles to expand and contract the body and pump air through the system.

JUMPING

A large grasshopper such as a locust can jump about a metre (twenty body lengths) without using its wings; the acceleration peaks at about 20 g. Grasshoppers jump by extending their large back legs and pushing against the substrate (the ground, a twig, a blade of grass or whatever else they are standing on); the reaction force propels them into the air. They jump for several reasons; to escape from a predator, to launch themselves for flight, or simply to move from place to place. For the escape jump in particular there is strong selective pressure to maximize take-off velocity, since this determines the range. This means that the legs must thrust against the ground with both high force and a high velocity of movement. However, a fundamental property of muscle is that it cannot contract with both high force and high velocity, which seems like a problem. Grasshoppers overcome this apparent contradiction by using a catapult mechanism to amplify the mechanical power produced by their muscles.

The jump is a three-stage process. First, the grasshopper fully flexes the lower part of the leg (tibia) against the upper part (femur) by activating the flexor tibiae muscle (the back legs of the immature grasshopper in the top photograph are in this preparatory position). Second, there is a period of co-contraction in which force builds up in the large, pennate extensor tibiae muscle, but the tibia is kept flexed by the simultaneous contraction of the flexor tibiae muscle. The extensor muscle is much stronger than the flexor muscle, but the latter is aided by specializations in the joint that give it a large effective mechanical advantage over the former when the tibia is fully flexed. Co-contraction can last for up to half a second, and during this period the extensor muscle shortens and stores elastic strain energy by distorting stiff cuticular structures in the leg. The extensor muscle contraction is quite slow (almost isometric), which allows it to develop high force (up to 14 N in the desert locust), but because it is slow only low power is needed. The third stage of the jump is the trigger relaxation of the flexor muscle, which releases the tibia from the flexed position. The subsequent rapid tibial extension is driven mainly by the relaxation of the elastic structures, rather than by further shortening of the extensor muscle. In this way the stiff cuticle acts like the elastic of a catapult, or the bow of a bow-and-arrow. Energy is put into the store at low power by slow but strong muscle contraction, and retrieved from the store at high power by rapid relaxation of the mechanical elastic structures.

LIFECYCLE AND REPRODUCTION

Grasshoppers lay their eggs in pods in the ground near food plants, generally in the summer. The eggs in the pod are glued together with a froth in some species. After a few weeks of development, the eggs of most species go into diapause, and pass the winter in this state; in a few species the eggs hatch in the same summer they were laid. Diapause is broken by a sufficiently low ground temperature; development resumes as soon as the ground warms above a threshold temperature. The embryos in a pod generally all hatch out within a few minutes of each other. They soon shed their membranes and their exoskeletons harden. These first instar nymphs can then jump away from predators.

Grasshoppers have incomplete metamorphosis: they repeatedly moult (undergo ecdysis), becoming larger and more like an adult, with for instance larger wing-buds, in each instar. The number of instars varies between species. At the final moult, the wings are inflated and become fully functional. The migratory grasshopper, Melanoplus sanguinipes, spends about 25–30 days as a nymph depending on sex and temperature, and about 51 days as an adult.

Males stridulate, rapidly rasping the hind femur against the forewing to create a churring sound, to attract mates. Females select suitable egg-laying sites, such as bare soil or near the roots of food plants according to species. Males often gather around an ovipositing female; in some species she is mated as soon as she takes her ovipositor out of the ground. After laying the eggs, the female covers the hole with soil and litter.

PREDATORS, PARASITES AND PATHOGENS

Grasshoppers have a wide range of predators at different stages of their life-cycle. Eggs are eaten by bee-flies, ground beetles and blister beetles. Hoppers and adults are taken by predators including other insects such as ants, robber flies and sphecid wasps; spiders; many birds; and small mammals.

Parasitoids include blowflies, fleshflies, and tachinid flies. External parasites include mites. It has been found that female grasshoppers parasitised by mites produce fewer eggs and thus have fewer offspring. This is probably because the individuals concerned allocate resources in response to the parasitism which are then not available for reproduction.

Spinochordodes tellinii and Paragordius tricuspidatus are parasitic worms that infect grasshoppers and alter the behaviour of their hosts. The grasshopper is persuaded to leap into a nearby body of water where it drowns, thus enabling the parasite to continue with the next stage of its life cycle which takes place in water. The grasshopper nematode (Mermis nigrescens) is a long slender worm that infests grasshoppers, living in the insect's hemocoel. Adult worms lay eggs on plants and the host gets infected when it eats the foliage.Grasshoppers are affected by diseases caused by bacteria, viruses, fungi and protozoa. The bacteria Serratia marcescens and Pseudomonas aeruginosa have both been implicated in causing disease in grasshoppers, as has the entomopathogenic fungus Beauveria bassiana. This widespread fungus has been used to control various pest insects around the world, but although it infects grasshoppers, basking in the sun has the result of raising the insect's temperature above a threshold tolerated by the fungus, and the infection is not lethal. The fungal pathogen Entomophaga grylli is able to influence the behaviour of its grasshopper host, causing it to climb to the top of a plant and cling to the stem as it dies. This ensures wide dispersal of the fungal spores liberated from the corpse.The fungal pathogen Metarhizium acridum is found in Africa, Australia and Brazil where it has caused epizootics in grasshoppers. It is being investigated for possible use as a microbial insecticide for locust control. The microsporidian fungus Nosema locustae, once considered to be a protozoan, can be lethal to grasshoppers. It has to be consumed by mouth and is the basis for a bait-based commercial microbial pesticide. Various other microsporidians and protozoans are found in the gut.

ANTI-PREDATOR DEFENCES

Grasshoppers exemplify a range of anti-predator adaptations, enabling them to avoid detection, to escape if detected, and in some cases to avoid being eaten if captured. Grasshoppers are often camouflaged to avoid detection by predators that hunt by sight. Their colouration usually resembles the background, whether green for leafy vegetation, sandy for open areas or grey for rocks. Some species can change their colouration to suit their surroundings.

Several species such as the hooded leaf grasshopper Phyllochoreia ramakrishnai (Eumastacoidea) are detailed mimics of leaves. Grasshoppers often have deimatic patterns on their wings, giving a sudden flash of bright colours that may startle predators long enough to give time to escape in a combination of jump and flight.

Some species are genuinely aposematic, having both bright warning coloration and sufficient toxicity to dissuade predators. Dictyophorus productus (Pyrgomorphidae) is a "heavy, bloated, sluggish insect" that makes no attempt to hide; it has a bright red abdomen. A Cercopithecus monkey that ate other grasshoppers refused to eat the species. Another species, the rainbow or painted grasshopper of Arizona, Dactylotum bicolor (Acridoidea), has been shown by experiment with a natural predator, the little striped whiptail lizard, to be aposematic.

RELATIONSHIP WITH HUMANS

IN ART

Grasshoppers are occasionally depicted in artworks, such as the Dutch Golden Age painter Balthasar van der Ast's still life oil painting, Flowers in a Vase with Shells and Insects, c. 1630, now in the National Gallery, London, though the insect may be a bush-cricket.

Another orthopteran is found in Rachel Ruysch's still life Flowers in a Vase, c. 1685. The seemingly static scene is animated by a "grasshopper on the table that looks about ready to spring", according to the gallery curator Betsy Wieseman, with other invertebrates including a spider, an ant, and two caterpillars.

Symbolism

Grasshoppers are sometimes used as symbols, as in Sir Thomas Gresham's gilded grasshopper in Lombard Street, London, dating from 1563;[a] the building was for a while the headquarters of the Guardian Royal Exchange, but the company declined to use the symbol for fear of confusion with the locust.

When grasshoppers appear in dreams, these have been interpreted as symbols of "Freedom, independence, spiritual enlightenment, inability to settle down or commit to decision". Locusts are taken literally to mean devastation of crops in the case of farmers; figuratively as "wicked men and women" for non-farmers; and "Extravagance, misfortune, & ephemeral happiness" by "gypsies".

AS FOOD

In some countries, grasshoppers are used as food. In southern Mexico, grasshoppers, known as chapulines, are eaten in a variety of dishes, such as in tortillas with chilli sauce. Grasshoppers are served on skewers in some Chinese food markets, like the Donghuamen Night Market. Fried grasshoppers (walang goreng) are eaten in the Gunung Kidul area of Yogjakarta, Java in Indonesia. In the Arab world, grasshoppers are boiled, salted, and sun-dried, and eaten as snacks. In Native America, the Ohlone people burned grassland to herd grasshoppers into pits where they could be collected as food.

It is recorded in the Bible that John the Baptist ate locusts and wild honey (Greek: ἀκρίδες καὶ μέλι ἄγριον, akrides kai meli agrion) while living in the wilderness; attempts have been made to explain the locusts as suitably ascetic vegetarian food such as carob beans, but the plain meaning of ἀκρίδες is the insects.

AS PESTS

Grasshoppers eat large quantities of foliage both as adults and during their development, and can be serious pests of arid land and prairies. Pasture, grain, forage, vegetable and other crops can be affected. Grasshoppers often bask in the sun, and thrive in warm sunny conditions, so drought stimulates an increase in grasshopper populations. A single season of drought is not normally sufficient to stimulate a massive population increase, but several successive dry seasons can do so, especially if the intervening winters are mild so that large numbers of nymphs survive. Although sunny weather stimulates growth, there needs to be an adequate food supply for the increasing grasshopper population. This means that although precipitation is needed to stimulate plant growth, prolonged periods of cloudy weather will slow nymphal development.

Grasshoppers can best be prevented from becoming pests by manipulating their environment. Shade provided by trees will discourage them and they may be prevented from moving onto developing crops by removing coarse vegetation from fallow land and field margins and discouraging luxurious growth beside ditches and on roadside verges. With increasing numbers of grasshoppers, predator numbers may increase, but this seldom happens sufficiently rapidly to have much effect on populations. Biological control is being investigated but with little success. On a small scale, neem products can be effective as a feeding deterrent and as a disruptor of nymphal development. Insecticides can be used, but adult grasshoppers are difficult to kill, and as they move into fields from surrounding rank growth, crops may soon become reinfested.

Grasshoppers, like the Chinese rice grasshopper, are a pest in rice paddies. Ploughing exposes the eggs on the surface of the field, to be destroyed by sunshine or eaten by natural enemies. Some eggs may be buried too deeply in the soil for hatching to take place.

LOCUSTS

Locusts are the swarming phase of certain species of short-horned grasshoppers in the family Acrididae. It has been shown that swarming behaviour is a response to overcrowding. Increased tactile stimulation of the hind legs causes an increase in levels of serotonin. This causes the grasshopper to change colour, feed more and breed faster. The transformation of a solitary individual into a swarming one is induced by several contacts per minute over a short period.

Following this transformation, under suitable conditions dense nomadic bands of flightless nymphs can occur, producing pheromones which attract them to each other. With several generations in a year, the locust population can build up from localised groups into vast accumulations of flying insects known as plagues, devouring all the vegetation they encounter. The largest recorded locust swarm was one of the now-extinct Rocky Mountain locust in 1875, which was 2,900 km long and 180 km wide.

An adult desert locust can eat about 2 g each day so the billions of insects in a large swarm can be very destructive, stripping all the foliage from plants in an affected area and also consuming stems, flowers, fruits, seeds and bark. Locust plagues can have devastating effects on human populations, causing famines and population upheavals. They are mentioned in both the Koran and the Bible and have been held responsible for cholera epidemics, resulting from the corpses of locusts drowned in the Mediterranean Sea and decomposing on beaches.

The FAO and other organisations monitor locust activity around the world. Timely application of pesticides can prevent nomadic bands of hoppers joining together and proliferating before dense swarms of adults are built up. Besides conventional control using contact insecticides, biological pest control using the entomopathogenic fungus Metarhizium acridum which specifically infects grasshoppers has been used with some success

IN LITERATURE

The Egyptian word for locust or grasshopper was written snḥm in the consonantal hieroglyphic writing system. The pharaoh Ramesses II compared the armies of the Hittites to locusts: "They covered the mountains and valleys and were like locusts in their multitude."

One of Aesop's Fables, later retold by La Fontaine, is the tale of The Ant and the Grasshopper. The ant works hard all summer, while the grasshopper plays. In winter, the ant is ready but the grasshopper starves. Somerset

Maugham's short story "The Ant and the Grasshopper" explores the fable's symbolism via complex framing. The Canadian philosopher Bernard Suits retells the story with the grasshopper as "the exemplification of the life most worth living." Other human weaknesses besides improvidence have become identified with the grasshopper's behaviour. So an unfaithful woman (hopping from man to man) is "a grasshopper" in "Poprygunya", an 1892 short story by Anton Chekhov, and in Jerry Paris's 1969 film The Grasshopper.

The 1957 film Beginning of the End portrayed giant grasshoppers attacking Chicago. In the 1998 film A Bug's Life, the heroes are the members of an ant colony, and the lead villain and his henchmen are grasshoppers.

IN AVIATION

The name "Grasshopper" was used for light aircraft such as the Aeronca L-3 and Piper L-4 used for reconnaissance and other support duties in World War II.

WIKIPEDIA

This image is taken from United States Naval Medical Bulletin Vol. 13, Nos. 1-4, 1919 by Medical Heritage Library, Inc.

Go to the Book with image in the Internet Archive

Title: United States Naval Medical Bulletin Vol. 13, Nos. 1-4, 1919

Creator: U.S. Navy. Bureau of Medicine and Surgery

Publisher:

Sponsor:

Contributor:

Date: 1919

Language: eng

Table of Contents

Number 1

PREFACE vii

FRONTISPIECE:

Thomas Henry Huxley.

SPECIAL ARTICLES:

Heart sounds and their value.

By Lieutenant Commander H. A. Hare, Med. Corps, U. S. N. R. F. . 1

Eliminating the epileptic from the navy.

By Lieutenant L. E. Bisch, Med. Corps, U. S. N. R. F 6

The use of serum in lobar pneumonia.

By Lieutenant E. W. Gould, Med. Corps, U. S. N. R. F., and Lieutenant

M. Shaweker, Med. Corps, U. S. N 16

Diagnosis and treatment of pneumonia and empyema.

By Commander F. A. Asserson, Med. Corps., U. S. N., and Lieutenant W.

L. Rathbun, Med. Corps, U. S. N. R. F 26

Development of specific serum therapy in pneumonia.

By Lieutenant W. R. Redden, Med. Corps, U. S. N 36

Flatfoot.

By Lieutenant Commander L. R. G. Crandon, Med. Corps, U. S.N. R. F 43

Treatment of flat feet.

By Lieutenant (J. G.) S. B. Burk, Med. Corps, U. S. N. R. F 46

Ear protection.

By Commander G. B. Trible and Lieutenant S. S. Watkins, Med.

Corps, U. S. N 48

HISTORICAL.

Thomas Henry Huxley (1825-1895).

By Lieutenant Commander F. J. B. Cordeiro, Med. Corps, U. S.N., Ret 61

EDITORIAL.

Accuracy. —Military titles and military behavior. —Shell shock. 71

SUGGESTED DEVICES:

Typhoid prophylaxis cards.

By Lieutenant Commander R. B. Henry, Med. Corps, U. S. N 77

A SURGICAL DRESSING TRAY FOR SHIPS.

By Lieutenant M. J. Price. Med. Corps, U. S. N 78

A USEFUL FLYTRAP.

By Lieutenant H. V. Hughens, Med. Corps, U. S. N 80

Scale for measuring flatfoot.

By Lieutenant (J. G.) B. Dunham, Med. Corps, U. S. N R. F 82

CLINICAL NOTES:

A CASE OF STATUS LYMPHATICUS

By Lieutenant E. L. Rice, Med. Corps, U. S. N 85

Some practical and theoretical considerations.

By Lieutenant Commander J. J. A. McMullin, Med. Corps, U. S. N. 87

Pain in right hypochondrium and pernicious anemia.

By Lieutenant Commander H. M. Stenhouse, Med. Corps, U. S. N.. 89

Perforating wound of intestine and mesentery.

By Lieutenant G. G. Ross, Med. Corps, U. S. N. R. F 93

Treatment of scarlet fever.

By Lieutenant Commander W. C. Newton, Med. Corps, U. S. N. R. F. 94

Illustrative cases of atypical acute abdominal conditions.

By Lieutenant Commander G. D. Hale and Lieutenant J. C. Adams, Med.

Corps, U. S. N 95

Varieties of hypersusceptibility.

By Lieutenant L. K. McCafferty, Med. Corps, U. S. N 98

Varix simulating inguinal hernia.

By Lieutenant E. J. Cummings, Med. Corps, U. S.N 103

Appendicitis and ruptured meso-appendix artery.

By Lieutenant F. H. Bowman, Med. Corps, U. S. N 104

Unusual wound contamination.

By Lieutenant E. A. Stephens, Med. Corps, U. S. N 105

Subluxation of vertebra by muscular action.

By Commander I. S. K. Reeves and Lieutenant M. K. Miller, Med. Corps,

U.S.N 107

Fracture of the skull.

By Lieutenant Commander R. I. Longabaugh, Med. Corps, U. S. N.. 108

Report of case of stenosis of Wharton's duct.

By Lieutenant J. A. Halpin, Med. Corps, U. S. N 108

PROGRESS IN MEDICAL SCIENCES:

General medicine. —Status lymphaticus. —Epidemic of intestinal infection.

—New pathology of syphilis 111

Mental and nervous diseases. —Temperament and psychosis. War neuroses.

—Traumatic and emotional psychosis. —War neuroses. —Instinct distortion 117

Surgery. —Fascial transplants. —Chloralose as a general anesthetic 131

Military, legal and industrial. —Treatment of mustard-gas poisoning.

—Conference on medico-military administration. —Illegitimacy in Norway.

—Prevention of blindness.- —Aniline poisoning. —Immigration

statistics. —Preservation of fruit.—Economic and financial assistance given

by the United States 133

REPORTS:

SURGICAL EXPERIENCES AT THE FRONT.

By Lieutenant G. G.Ross, Med. Corps, U. S.N. R. F 145

Details of transport service.

By Lieutenant Commander R. I. Longabaugh, Med. Corps, U. S. N.. 149

Plan of a regimental field hospital.

By Lieutenant Commander C. B. Camerer, Med. Corps, U. S. N 156

The preparation of blood stain at the U. S. Naval Medical School.

By Lieutenant Commander G. F. Clark, Med. Corps, and Chief Pharmacist's

Mate L. F. Shabek, U. S. N 157

Preparation of identification tags.

By Lieutenant Commander R. H. Laning, Med. Corps, U. S. N 157

A death following salvarsan.

By Lieutenant R. C. Christiansen, Med. Corps, U. S. N 158

Sanitary report on the Island of Corfu.

By Lieutenant Commander H. Shaw, Med. Corps, U. S. N 163

The march and the shoe.

By Lieutenant Commander W. L. Mann, Med. Corps, U. S. N 164

Tuberculin test in young adults.

By Lieutenant E. Moody, Med. Corps, U. S. N. R. F., and Lieutenant C.

F. Carter, Med. Corps, U. S. N 165

Bed screens in barracks.

By Commander P. S. Rossiter, Med. Corps, U. S. N 167

Influenza on a naval transport.

By Lieutenant W. F. McAnally, Med. Corps, U. S. N 168

The treatment of chancroids and the prevention of buboes.

By Lieutenant G. W. Millett, Med. Corps, U. S. N 170

Record of the navy recruiting station, Pittsburgh, Pa.

By Lieutenant C. C. Ammerman, Med. Corps, U. S. N. R. F 171

Strength of the navy 172

BOOK NOTICES 173

NOTICE TO SERVICE CONTRIBUTORS 175

Number 2

PREFACE v

SPECIAL ARTICLES:

The pathology of pneumonia accompanying influenza.

By Lieutenants (J. G.) E. W. Goodpasture and F. L. Burnett, Medical

Corps, U. S. N. R. F 177

Mental examination of recruits.

By Lieutenant L. E. Bisch, Medical Corps, U. S. N. R. F 198

Treatment of military offenders.

By Lieutenant Commander A. L. Jacoby, Medical Corps, U. S. N. R. F..

229

Extraction of metallic foreign bodies.

By E. Robin, Medecin I ere Classe 237

New methods in amputations and prosthesis of the lower limbs.

By Lieutenant Commander R. G. LeConte, Medical Corps, U.S.N. R.F.. 244

Education and sanitation aboard ship.

By Commander W. S. Pugh, Medical Corps, U. S. N 254

HISTORICAL:

Jean Dominique Larrey 267

Extract from a surgical memoire by Baron Larrey.

Translated by Captain G. A. Lung, Medical Corps, U. S. N 275

EDITORIAL:

The lesson of job's war horse 283

SUGGESTED DEVICES:

Sanitary drinking fountain.

By Lieutenant Commander D. S. Hillis, Medical Corps, U. S. N. R. F. .

287

Clinical charts in health records.

By lieutenant (J. G.) J. J. Cancelmo, Medical Corps, U. S. N. R. F. .

287

System of clinical records.

By Captain W. B. Grove, Medical Corps, U. S. N., and Lieutenant G. B.

Crow, Medical Corps, U. S. N. R. F... 288

A DRESSING FOR WOUNDS.

By Lieutenant Commander C. W. C. Bunker, Medical Corps, U. S. N. 291

CLINICAL NOTES:

Abdominal wounds from hand grenade.

By Lieutenant J. M. Emmett, Medical Corps, U. S. N 293

Fracture of spine of tibia.

By Lieutenant Commander G. G. Ross, Medical Corps, U.S.N. R.F... 294

Fracture of pelvis.

By Lieutenant Commander G. G. Ross, Medical Corps, U. S. N . R. F . . .

295

Chronic rheumatism cured by appendectomy.

By Lieutenant R. H. Michels, Medical Corps, U. S. N. R. F 296

A CASE OF MYELOID LEUKEMIA.

By Lieutenant E. R. Ryan, Medical Corps, U. S. N 297

Pericardiotomy.

By Lieutenant Commander L. R. G. Crandon, Medical Corps, U. S. N.R. F

299

A CASE OF KERATOSIS PLANTARIS.

By Lieutenant J. M. Perret, Medical Corps, U.S.N 300

Influenza with unusual complications.

By Lieutenant (J. G.) F. G. Folken, Medical Corps, U. S. N. R. F.. 301

PROGRESS IN MEDICAL SCIENCES:

General medicine. —Diagnosis, treatment and prophylaxis of malaria in Brioni

— Epidemic lethargic encephalitis— Encephalitis lethargica — Syphilitic

aortitis —The pathology of the streptococcal pneumonias of Army camps— The

venereal problem and the war—The cocaine habit.

Surgery. —Sterilization of wounds by electro-ions — Abscess of thyroid following

septico-pyemia from otitis —Acute perforations of the abdominal viscera— The

use of paraffin for drainage in surgery — Surgical technic in orthopedic

surgery 307-320

Pathology, bacteriology, and animal parasitology. —Laboratory diagnosis—Detection

of spirochetes— Gonococcus infections 321

Eye, ear, nose and throat. —Tests for malingering in defective hearing

— Ocular anaphylaxis 334

NOTES AND COMMENTS:

The third resuscitation commission. — Lecture course at Great Lakes,

Ill.—A department of physical training —The Germans and the scientific workers

of Lille—Physical education — Transportation of sick and wounded — Traumatic

rupture of the spleen—Officer-material school at Princeton — Wanted, a

diagnosis 337

REPORTS:

Hospital administration.

By Captain G. A. Lung, Medical Corps, U. S. N 347

Removal of wounded from U. S. S. "Northern Pacific."

By Commander E. H. H. Old, Medical Corps, U. S. N 349

On board a torpedoed transport.

By Lieutenant Commander E. E. Curtis, Medical Corps, U.S.N 351

Influenza at the U. S. Naval Hospital, Washington, D. C.

By Rear Admiral R. M. Kennedy, Medical Corps, U. S. N 355

Notes on post-influenzal pneumonia.

By Lieutenant (J. G.) A. M. Burgess, Medical Corps, U. S. N. R. F., and

Phar. Mate E. J. Staff, U. S. N. R. F 356

Diphtheria at the U. S. Naval Academy.

By Lieutenant J. E. Houghton, Medical Corps, U. S. N., and Lieutenant

(J. G.) D. G. Richey, Medical Corps, U. S. N. R. F 359

Influenza at Pensacola.

By Lieutenants J. M. Perret, and C. M. Shaar, Medical Corps, TJ. S. N .

. 365

Training school for nurses in Haiti.

By Chief Nurse L. D. Jordan, U. S. N 378

Observation of candidates for the listener's school.

By Lieutenant F. B. Galbraith, Medical Corps, U. S. N 380

BOOK NOTICES 391

UNITED STATES NAVAL MEDICAL SCHOOL LABORATORIES.

Additions to pathological collections 393

NOTICE TO SERVICE CONTRIBUTORS 394

Number 3

PREFACE VII

SPECIAL ARTICLES :

Preventive medicine at training camps and stations.

By Captain C. E. Riggs, Medical Corps, U. S. N 395

With marines in France.

By Lieutenant F. E. Locy, Medical Corps, U. S. N 417

Bone grafts.

By Lieutenant Commander E. M. Foote, Medical Corps, U. S. N. R. F 433

Internal derangements or knee joints.

By Lieutenant ( J. G.) C. F. Painter, Medical Corps, U. S. N. R. F 442

Clinical manifestations of tropical sprue.

By Lieutenant Commander E. J. Wood, Medical Corps, U. S. N.R. F 449

Isolation and cultivation of Pfeiffer's bacillus.

By Lieutenant DeW. G. Rlchey, Medical Corps, U. S. N. R. F 453

Nervous element in aviation.

By Lieutenant G. U. Pillmore, Medical Corps, U. S. N 458

Administration of the U. S. Hospital Ship Solace.

By Commander E. E. H. Old, Medical Corps, U. S. N 478

HISTORICAL :

Devices and uniforms of the Navy Medical Corps 505

EDITORIAL :

The reform of funerals —The apotheosis of dungarees 515

IN MEMORIAM :

Henry G. Beyer.

By Lieutenant (T.) P. J. Waldner, Medical Corps, U. S. N 521

Washington Berry Grove.

By Lieutenant Commander L. M. Schmidt, Medical Corps, U. S. N_ 522

SUGGESTED DEVICES :

Improvised mess tables.

By Captain H. C. Curl, Medical Corps, U. S. N 1 525

Apparatus for submersion cases.

By Captain G. F. Freeman, Medical Corps, U. S. N 525

Recording dental operations.

By Lieutenant W. F. Murdy, Dental Corps, U. S. N 527

CLINICAL NOTES :

Rupture of the esophagus.

By Lieutenant Commander L. Sheldon, Medical Corps, U. S. N 529

Anthrax cured by vaccine.

By Lieutenant (J. G.) J. K. Leasure, Medical Corps, U. S. N. R. F 581

Foreign body in antrum.

By Lieutenant J. B. Greene, Medical Corps, U. S. N. R. F 534

Traumatic rupture of kidney.

By Lieutenant Commander P. H. Bowman. Medical Corps, U. S. N., and

Lieutenant Commander H. D. Meeker, Medical Corps, U. S. N. R. F 536

Thrombosis of popliteal vein.

By Lieutenant C. A. Frink, Medical Corps, U. S. N. R. F 538

Alopecia Universalis.

By Captain A. R. Alfred, Medical Corps, U. S. N 539

Operations for rupture of kidney and spleen.

By Lieutenant C. O. Tanner, Medical Corps, U. S. N 539

Traumatic aneurism : Five cases.

By Lieutenant Commander F. H. Bowman, Medical Corps, U. S. N. and

Lieutenant Commander H. D. Meeker, Medical Corps, U. S. N. R. F 541

A DEATH FROM SALVARSAN.

By Lieutenant E. F. Crofutt, Medical Corps, U. S. N. R. F 543

Perforation of Meckel's diverticulum.

By Lieutenant W. F. Pearce, Medical Corps, U. S. N 546

Syphiloma of cererrum.

By Lieutenants A. W. Hoaglund and P. F. Prioleau, Medical Corps, U. S.

N 547

Extra-genital chancre.

By Lieutenant Commander C. B. Camerer and Lieutenant J. R. Poppen,

Medical Corps, U. S. N 551

Chancre of the thumb.

By Lieutenant (J. G.) L. Herman, Medical Corps, U. S. N. R. F. 553

Typhoid fever with severe complications.

By Lieutenant F. N. Martin, Medical Corps, U. S. N. R. F 554

Cholangitis following influenza.

By Lieutenant R. S. Reeves, Medical Corps, U. S. N. R. F 557

Diphtheria complicating fractured mandible.

By Lieutenant (J. G.) J. B. Goodall, Dental Corps, U. S. N. R. F. 559

PROGRESS IN MEDICAL SCIENCES :

General medicine. —Tests of physical efficiency — Malaria as a military

problem —Anthelmintics as tested on earthworms —New treatment of bichloride

poisoning —Corpeus luteum and vomiting of pregnancy 561

Surgery. —Post-operative parotitis —The empyema problem — Skin disinfection

by picric acid — Reconstructive surgery of the hand and forearm 573

Pathology, bacteriology, and animal parasitology. — Bacteriology of

tuberculous kidneys — Hermann-Perutz reaction — Experiments with virus of

grippe 578

Eye, ear, nose, and throat.— Perineural anesthesia for surgery of maxillary

sinus —Intraocular pressure and tonometry 5S2

NOTES AND COMMENTS :

Transmission of venereal disease may constitute assault — Interdepartmental

Social Hygiene Board— Sir Charles Wyndham —Harvard surgical unit— Retail

druggists and quack remedies — School of Hygiene, Johns Hopkins University —

Legal decision re vaccination —American merchant marine —Meningococci in blood

—Radium conservation —Andre Chantemesse 585

REPORTS :

The U. S. hospital ship "Comfort."

By Captain A. W. Dunbar, Medical Corps, U. S. N. 591

Voyage of the U. S. S. "Leviathan."

By Commander F. A. Asserson, Medical Corps, U. S. N 602

Ship life in Constantinople.

By Lieutenant Commander E. P. Huff, Medical Corps, U. S. N 605

A record ship.

By Lieutenant Commander A. E. Lee, Medical Corps, U. S. N 609

U. S. Naval Air Station, Pauillac, France.

By Lieutenant Commander H. A. Garrison, Medical Corps, U. S. N 611

U. S. Naval Air Station, Rockaway Beach, L. I.

By Lieutenant ( J. G. ) A. A. Shadday, Medical Corps, U. S. N. R. F 616

Increase of weight under service conditions.

By Lieutenant H. Halstead and Lieutenant (J. G.) E. A. Mallon, Medical

Corps, U. S. N. R. F 620

Poisoning by trinitrotoluol.

By Lieutenant (J. G.) A. Saska, Medical Corps, U. S. N. R. F 624

The marine shoe.

By Lieutenant Commander W. L. Mann, Medical Corps, U. S. N__ 625

X-RAY WORK AT A NAVAL HOSPITAL.

By Lieutenant C. H. Jennings, Medical Corps, U. S. N. R. F 628

Dental work at the navy yard, New York.

By Lieutenant Commander R. Barber, Dental Corps, U. S. N 631

Dental work at the navy yard, Mare Island, Cal.

By Lieutenant Commander J. L. Brown, Dental Corps, U. S. N 632

BOOK NOTICES 633

NOTICE TO SERVICE CONTRIBUTORS 635

Number 4

PREFACE .. vii

SPECIAL ARTICLES :

Report on the influenza epidemic.

By the Staff of the U. S. Naval Hospital, Philadelphia 837

Infectious and contagious diseases. Virgin Islands, 1918.

By Lieutenant E. Peterson, Medical Corps, U. S. N 682

Naval ambulance trains in Great Britain.

By Captain P. L. Pleadwell, Medical Corps, U. S. N 706

Bone surgery.

By Lieutenant Commander A. L. Clifton, Medical Corps, U. S. N__ 718

An epidemic of mumps.

By Lieutenant Commander R. B. H. Gradwohl, Medical Corps, U. S. N. R. F.

; Lieutenant C. F. Carter, Medical Corns, U. S. N. ; Lieutenant W. S. Barcus

and Lieutenant (J. G.) H. L. Fougerousse, Medical Corps, U. S. N. R. F. 723

Constitutional inferiority in the Navy.

By Lieutenant T. A. Ratliff, Medical Corps, U. S. N. R. F 728

Acute early appendicitis.

By Lieutenant Commander H. E. Jenkins. Medical Corps, U. S. N., and

Lieutenant L. A. Will, Medical Corps, U. S. N. R. F 733

Extra-genital chancres.

By Lieutenant .T. M. Perret, Medical Corps. U. S. N. R. F 736

Incubation and choice of antigens in the Wassermann reaction.

By Lieutenant E. D. Hitchcock, Medical Corps, U. S. N. R. F 740

HISTORICAL:

The practice of medicine in Europe during the Middle Ages 747

EDITORIAL : Intangible damage—The "Attitude of the Bureau"

775

IN MEMORIAM :

Abraham Jacobi (1830-1919) 781

SUGGESTED DEVICES :

The construction of animal cages.

By Lieutenant Commander G. F. Clark, Medical Corps, U. S. N 783

A ROTARY TOOTHBRUSH.

By Lieutenant Commander H. E. Harvey, Dental Corps, U. S. N_ 783

Equipment of battle dressing station storerooms.

By Commander W. S. Pugh, Medical Corps, U. S..N 786

CLINICAL NOTES :

Poisoning by bay rum containing wood alcohol.

By Lieutenant N. S. Betts, Medical Corps, U. S. N. R. F 791

Arsenic poisoning following the use of novarsenobenzol.

By Lieutenant C. M. Burchflel, Medical Corps, U. S. N 795

Death following arsphenamine. Page.

By Lieutenant A. Goetsch, Medical Corps, U. S. N 797

High temperature in influenza.

By Lieutenant (J. G.) P. M. Williams, Medical Corps, U. S. N. R. F 799

Voiding of a bullet from the bladder.

By Lieutenant Commander F. H. Bowman, Medical Corps, U. S. N . 799

Depressed fracture of frontal bone.

By Lieutenant A. W. Hoagland, Medical Corps. U. S. N 800

Colon ptosis.

By Lieutenant G. U. Plllmore, Medical Corps, U. S. N 801

Ideal tonsil operation.

By Lieutenant Commander A. H. Robnett, Medical Corps,

U. S. N 06

PROGRESS IN MEDICAL SCIENCES :

General medicine. — Bacillus botulinus poisoning 800

Surgery.—Pathological possibilities of neglected gallstone disease 811

Hygiene and sanitation. — Historical Inquiry into the efficacy of lime

juice for the prevention and cure of scurvy —The ship's water supply 813

Pathology, bacteriology, and animal parasitology. — Vaccine treatment

of filarial lymphangitis in British Guiana —Blood destroying substance in

ascarls lumbrlcoldes 817

Chemistry and pharmacy. —New titration method for the determination of

uric acid in urine — Modifications of Benedict's and Folin's quantitative sugar

methods—Food ingestion and energy transformations with special reference to the

stimulating effect of nutrients —Nutritive factors In animal tissues 819

Eye, ear, nose, and throat. —Methylene blue in purulent discharge from

the eye socket—Prophylactic use of pitultrin in nose and throat operations

under general and local anesthesia —Colloidal manganese in gonorrheal

ophthalmia —Hemorrhage following the removal of the tonsils and its treatment

821

NOTES AND COMMENTS:

The devastation of France— Peking Medical School —Vaccination in California

— Internal decoration of hospitals —Interallied conference on medical aspects

of aviation —U. S. Interdepartmental Social Hygiene Board—War Risk Insurance

Bureau —Boy Scouts — Legal control of motion pictures — Influenza statistics,

Great Lakes,

111— Sixth Division, Bureau of Navigation 823

REPORTS :

Naval railway battery in France.

By Lieutenant Commander C. S. Stephenson, Medical Corps, U. S. Navy 831

Submarine Division Five.

By Lieutenant Commander E. W. Brown, Medical Corps, U. S. N. 846

Preparation of antihuman amboceptor.

By Lieutenant Commander G. F. Clark, Medical Corps, U. S. N., and Chief

Pharmacist's Mate A. J. Mouton, U. S. N 853

Psychiatric work among recruits.

By Lieutenant F. L. McDaniel, Medical Corps, U. S. N 854

Bacteriological experiments with acriflavine.

By Lieutenant H. B. LaFavre. Medical Corps, U. S. N 858

Acriflavine In The Treatment Of Gonorrhea.

By Lieutenant C. M. Burchflel, Medical Corps. U. S. N 869

The army bedside x-ray unit.

By Lieutenant H. R. Coleman, Medical Corps, U. S. N 866

Hospital service in Haiti.

By Lieutenant Commander H. F. Lawrence, Medical Corps, U. S. N 869

Organization of the U. S. naval hospital, Charleston, S. C.

By Commander W. M. Garton and Lieutenant Commander G. W. Calver,

Medical Corps, U. S. N 876

BOOK NOTICES 897

NOTICE TO SERVICE CONTRIBUTORS 901

INDEX 903

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El desayuno by Claudia Pino

Tibia mañana en La Habana, Cuba.

Threshold of Sanity by ygchan

(It's a tree. Covered in lights. At the Lincoln Park Zoo.)

Nine months ago, on March 18th, I tore my left anterior cruciate ligament while skiing. I didn't even know it happened, just that I twisted my knee, felt a pop, and while skiing down, my knee sometimes slipped laterally when I pushed off of it. Seventeen days later, I had surgery. They had numbed my entire left leg by injecting lidocaine near my femoral and sciatic nerves. The entire limb was limp and flaccid, a bulky slab of flesh. In three hours, my surgeon, JML3, sliced my knee open, extracted the middle third of my patellar tendon and bone as a graft, drilled through my tibia and femur, threaded the graft through, screwed some plastic in there…Twenty hours later, my leg awoke from its sedated, zombie state. The subsequent journey was nothing I had planned, anticipated nor ever conceived--a journey of mental, intellectual, emotional, physical anguish, confusion, amusement and curiosity. Some of it I documented and described previously. Gross feelings, revelations on knee surgery, molecular basis of healing, the unknowns, the inevitable morbidity, why's, how's, what to do about it all took residence in my brain. I have since endeavored to figure all these things out. I learned you cannot find anything meaningful by querying "gimp" or "gimpy" in the NCBI PubMed literature search.

Thus, a list of ten memorable knee things I read:

1. Mechanisms of Anterior Cruciate Ligament Injury in World Cup Alpine Skiing

See, I'm not crazy. There's a technical term describing how I tore my ACL. It's called the "slip-catch mechanism." Yeah, that's right, I'm a World Cup alpine skier. Not.

2. The "Ligamentization" Process in Anterior Cruciate Ligament Reconstruction

Published two weeks after my surgery, this literature review describes the healing process of the ACL graft as observed in numerous animal models and biopsied samples from humans. I read it and freaked out when I came upon the part where they described the graft becoming necrotic about four weeks post-surgery. Necrosis = cell death, in an unnatural, destructive manner. The thing in my knee was dying. Rotting. Zombifying. Gag.

3. Observations on a Retrieved Patellar Tendon Autograft Used to Reconstruct the Anterior Cruciate Ligament : A Case Report

A 26-year old man, 18-months post-ACL surgery, died. They took his knee, cut it apart and looked at it. It was mostly healed and the graft had integrated in such a way that looked normal. The bone plugs of the graft were indeed necrotic (acellular) at the core, but the periphery had viable cells and had fused to the femoral and tibial tunnels. The tendonous portion of the graft, also necrotic at the core, had otherwise revascularized and was re-colonized by fibroblasts. Until this study, observations of the stages of healing and graft incorporation were based on animal studies; healing in humans were based on superficial biopsies.

4. Potential of Skin Fibroblasts for Application to Anterior Cruciate Ligament Tissue Engineering

They synthesized an ACL graft in vitro and put it into a goat! Two bone scaffolds from a pig, a string between the two bone plugs, some goat ACL fibroblasts, artificial growth media, exogenous collagen, one week in an incubator, and voila! De novo synthesis of a graft. After being put into a goat, the graft became vascularized and innervated and colonized by cells. It got remodeled in the goat's knees, as would the usual other grafts. But it was weak, only 36% of the strength of the native ACL after 13 months. Nevertheless, impressive!

5. Comparison of Traditional and Subcutaneous Patellar Tendon Harvest : A Prospective Study of Donor Site-Related Problems After Anterior Cruciate Ligament Reconstruction Using Different Graft Harvesting Techniques

Forty days post-surgery, I finally hit the wall and became impatiently frustrated by the gross feelings in my knee and adjacent part of my lower leg. It made it very hard to focus on the tasks at hand. Then, I realized my skin, lateral and inferior to my scar/incision site was numb to both touch and temperature. Epidermal insensitivity. This was the first article I found that helped me make sense of this. Damage to the dermatome--in particular, the infrapatellar nerve, a branch of the saphenous nerve, which runs down the inside of your leg. This article also made me aware of the long-term post-surgical knee morbidity that I would come to experience. Not everything would be honky-dory after all. At the time, I only cared about the feeling in my skin, since I could quantify it. They reported the numbness would persist, probably forever. I followed the changes weekly. I still exhibit 22.7 square centimeters of numbness to touch.

6. Biomechanical Measures During Landing and Postural Stability Predict Second Anterior Cruciate Ligament Injury After Anterior Cruciate Ligament Reconstruction and Return to Sport

On my second day of physical therapy, 18 days post-surgery, I rode on a stationary bicycle. At the time, I was still wearing my brace locked in full extension. I only ever took the brace off to shower and do my physical therapy exercises and had yet to bear weight on my left leg without the brace (that's right, I had to sleep with the thing on--it sucked). The muscles were functionally retarded and unable to coordinate my weight when my knee was bent. I recall asking my physical therapist, "How do I get on the bike with only one leg?" Looking unconcerned, she said, "You'll figure it out." Man, tough crowd. I hopped over and managed to mount the thing. Afterwards, when it was time to get off, I didn't even bother asking how I should best do this, and just pushed off the seat and hopped down onto my right leg. At that moment, my physical therapist, in a serious tone, said, "Careful! You don't want to tear your other ACL." Me, horrified, baffled, whimpered, "What?! That can happen?" Yeah, that can happen. I found this paper and it was ghastly. Of 33 female athletes that had undergone ACL reconstruction, 10 of them tore their ACL a second time. 76% of the time, it happened in the other leg! I showed this paper to my physical therapist and she said to me, "You shouldn't be reading this type of material. It's best to focus on recovery and prevention." I justified to myself that this fits under prevention. PREDICTORS of secondary tears, hence, things I need to work on.

7. Gluteus Medius: Applied Anatomy, Dysfunction, Assessment, and Progressive Strengthening

Physical therapy? What is that? I was walking fine before surgery, why can't I do it after? Two months post-surgery and the pieces were still not yet falling into place in my head, and many things I was experiencing I still had not found a decent explanation for. I just didn't get it. In addition, I wanted to know why I was doing bizarre exercises in physical therapy. My physical therapist, who treated me for four months from the time after surgery, humored my curiosity and inquiries. She gave me this review. It became a gateway article to my queries into understanding the biomechanics of one's lower extremities, how strengthening the gluteal muscles subsequently aid to stabilize your knees, ankles, everything. I followed the key words that led to my realization that rupturing of the ACL results in loss of neuromuscular signaling of the knee to brain about joint position, gait abnormalities, increased internal rotation of the tibia, confused and weakened the quadriceps and hamstrings…consequences that at this time I had assumed only to affect my balance and coordination.

8. ACL Surgery: How to Get It Right the First Time and What to Do If It Fails

This is a really informative textbook. It has almost everything you need to know about anatomy, diagnosis, biological mechanisms that lead to the failure of the graft to heal itself, types of grafts, fixation devices, pros/cons and technical specifications of these hardware, the technicalities and variations of the surgery (it's crazy complex!), a generalized gist of the molecular healing process, plus what to expect post-surgery in terms of rehabilitation and muscle weakness and inflammation and answers to many of those "why" questions I had (that I had eventually found in circuitous searches through the scientific literature), minus the experimental details. You would be surprised how most mechanical graft failures are attributed to technical errs of the surgery (i.e. graft installed at a bad angle, poor screw fixation, missed/improper diagnoses, etc).

It would have been nice to read this before surgery, though I might have been grossed out by the gory surgical photos of splayed open knees. I went into the surgery entirely naive about what to expect afterward and why. The extent of my knowledge was "Brace locked in full extension for four weeks, in brace unlocked to flex to 90 degrees until six weeks, walking unfettered afterwards, running at 3-4 months, cutting/pivoting at 5 months, back to sports at 6 months. Increased rate of osteoarthritis. Some discomfort at the scar when kneeling." Sounded easy--perhaps this was for the best?

9. Knee Function and Prevalence of Knee Osteoarthritis After Anterior Cruciate Ligament Reconstruction

The first scientific article I came upon of many on this topic. Ultimately (as gleaned from other papers), osteoarthritis (OA) appears to be a direct consequence of the ACL rupture. The twisting of the knee, tearing other things, and banging of the bones (bone and cartilage bruising) may contribute, but simply snipping (transection of) the ligament alone is sufficient to immediately induce the cellular signals that precipitate the joint and cartilage degeneration. Severing of the ligament physically destroys neuromuscular transmission between the ligament to adjacent muscles and the brain. An intra-articular blood vessel is usually ruptured, resulting in joint effusion, inhibition of quadricep function, and unfavorable changes to the articular environment: plasmin dismantling of the fibrin clot that forms as a healing scaffold on the torn ligament; upregulation of matrix metalloproteases that destroy the cartilage and matrix proteins in the joint that serve as lubrication; inflammatory cytokine signaling that affect chondrocyte (the cartilage producing cells) metabolism and viability; reduction of proteoglycan IV (aka lubricin), a "lubricating" joint matrix protein that buffers the cartilage and stimulates chondrocyte activity. The altered neuromuscular signaling also leads to muscular weakness, gait changes, force loading on different parts of the cartilage in the joint, increased friction and wearing of the cartilage, factors of which are not entirely restored by surgery or rehabilitation… Regardless of reconstruction, ACL tears have been reported to lead to osteoarthritis in 20-80% of the population 10-12 years post-injury, 90% OA by 15 years, 45% total knee arthroplasty (replacement) by 35 years. A pretty grim and sobering outlook.

I am not a fan of having a statistically sealed fate and I am thus holding out a small sliver of hope that I can be the anomaly that defies these near-inevitable odds.

10. Phys Ed: Can Running Actually Help Your Knees? (New York Times Article)

There's a lot of interesting reading in the Wellness blog section of the NYTimes. Anyway, there's no defined protocol on how to avoid OA, nor what differentiates those 10% of people that don't get it in 15 years from the 90% that do. However, numerous correlative studies have found that physical activity keeps the joints lubed up and healthier. They advocate low-impact activities, but without consistent and definitive empirical justification. This article, and many others, discuss observations on how in runners, chondrocytes in the knees continually produce cartilage and maintain cartilage volume; this is in contrast to sedentary folks, where cartilage thinning is observed. The consequences are not clearly defined for previously injured knees, but assuming aberrant cartilage loading due to neuromuscular imbalances, repetitive impact would accelerate joint degeneration. On the other hand, exercise increases and maintains muscular strength, and weight-bearing exercises have, in some cases, been observed to increase cartilage surface area and/or thickness.... I'm going to figure out an experiment to do that involves running. It will span a decade. We will see what happens to me. At worst, I will get OA and require a knee replacement, which at this rate, will occur with a 45% likelihood.

Another reason to run? "Runner's high" is actually from increased production of endocannabinoids, not endorphins. Endocannabinoids are fat-soluble signaling molecules, the same class of molecules acquired from use of marijuana. The lipid quality of these molecules allow them to readily cross the membranous blood-brain barrier and stimulate the brain to feel "high." Endorphins are proteinaceous, and thus do not readily diffuse through lipid membranes. Anyway, so running may be beneficial, if not for my left knee, then for my brain. I can feel it in my vastus medialis.