Calculus (dental)

Mathematics

Orthodontics

Medicine

Boston Medical and Surgical Journal

the aortic area, 19; systolic, at the aortic area and at the apex, 7 ; systolic at the apex, 2 ; heart enlarged to the left, 29; to the sixth space, 16; Corrigan pulse, 9; systolic thrill at the aortic area and transmitted to the neck, 2;_pulsus alternans, 2; cardiac compensation badly broken, 4.To support our diagnoses one has recourse to the Wassermann reaction and to roentgenographic examination.I shall therefore con- sider them next, Wassermann Reaction.As in other forms of syphilis the Wassermann reaction has been found to vary from strongly positive to nega- tive.Delafield and Prudden, in the latest edition of their book place the test as positive in all but 5 per cent, of the cases of specific aor- titis.3''In 36 cases of aortic disease Cummer and Dexter4" reported a positive reaction in 27, or 75 per cent.; and Longcope2" in 35 (or 74.5 per cent.) of 47 cases.The latter author, in summing up the percentage of positive Was- sermann reaction, gives the figures as: from 25 to 68 in general cardiovascular disease, from 75 to 80 in aortic insufficiency, from 85 to 95 in aneurysm.and 75 to 88 in aortic disease in general.20But I should like more especially to draw attention to the frequency of a negative response to the Wassermann test and to the interpretation which should be placed on the absence of a positive reaction in the diagnosis of syphilis of the aorta, Elliott, of Chicago, states that, in his experience, it is not uncom- mon in late syphilitic developments, such as tabes, aortitis and myocardial disturbance, to obtain a negative Wassermann reaction.Mix31 points out that Warthin has demonstrated the

Renal Calculus with Negative X-Ray Findings