The Diagnostic Value of the Plantar Response in Insulin Coma

Abstract

gland produets (ovarian, thyroid, pituitary)'. The following case may be quoted in illustration of these conditions. A primipara, aged .28, since the birth of a child two years prev-iously, which was nursed for seven months, had never felt well. There was complete amenorrhpoea, and she complained of leucorrhoea. She gained nearly 3 st. in weight. The skin was dry, and the hair falling out. .The first is the high cholesterin content of the blood in preggnancy, and which in the last months is about twice the normal (Moyniihan).2 The second is the tendency to the occurrence-of stasis in the biliary ducts during pregnancy.The third is the frequenicy with-which women who have boriie children suffer from focal sepsis in the pelvic, urinary, anid other regions. There is reason for the belief that infection of the gall-bladder usually precedes the depositioln of stones, and that this infection may reach the gall-bladder fromii some such distant source. Gall-bladder disease is notorious for .the frequent obscurity of its symptomatology.Where it is associated with local pain and tenderness, recurring biliary colic, and jaundice its recognition is easy. Often, lhowever, these cardinal features are absent, and its preselce owill be inissed-unless it is brought under suspicion in all cases of parous women, especially those tending to obesity, who suffer from chronic ill health, dyspepsia, and vague abdominal srmptoms. It is a common accompaniment of clhronic gynaecological disease. CONCLUSION.The woman suffering from chronic ill health dating from chiil-dbirth is frequently the-subject of multiple lesions. Failure to carry out a comprehensive investigation of the various systemus may lead to an imperfect diagnosis, resulting in operations and other forms of treatment that brilng little relief.