Name this abdominal mass?

Name this abdominal mass?

A 78 year woman presents with weight loss, lethargy and abdominal pain. Clinical examination showed abdominal distention and a firm, non-tender, irregular 1 cm nodule within the umbilicus.   What is this finding called? Sister Mary Joseph nodule (also called Sister Mary Joseph node or sign)   What does is represent? This is a palpable nodule

The Jugular Venous Pulse – Circa 1957

In 1902 Sir James Mackenzie published a book entitled “The Study of the Pulse. Arterial, venous, and hepatic and of the movements of the heart” that described his studies on the jugular pulse using what would later and famously be known as the “Mackenzie polygraph”. He was the first to make recordings of the arterial

10 Osler-isms to Remember in Your Daily Practice

William Osler’s life and work remains so instructive. Here at Stanford we invoke his name often, and have something we call an “Osler Evening” to honor him; these are evenings where we interview a faculty member on stage, getting to know a bit about their life, the journey they made to get where they are. Here are some

Erb and Westphal

by Damiana Andonova Wilhelm Heinrich Erb of Bavaria, an internist interested in neurology, was a professor in Heidelberg, Germany. He is most known for writing about the importance of deep tendon reflexes to the neurological exam in the January 1875 issue of Archiv fur Psychiatrie und Nervenkrankheiten. Carl Friedrich Otto Westphal was a professor in Berlin and an

The Birth of Percussion

It should come to no surprise to us that the invention of percussion came from the mind of a musician. Leopold Auenbrugger was a physician, but he was also a composer who wrote an opera for an Austrian empress. However the coming together of music and medicine had its origins in watching his father tap on the side of

The History of Bedside Ultrasound: From Submarines to Sub-Interns

By Michael Vogel Among the myriad of modern diagnostic tools, few can claim the certainty, consistency, and intimacy of ultrasound. In contrast to other dominant types of medical imaging characterized by large, foreign machines and uncomfortable noise and positioning, this sound-based imaging technique is one of the least intimidating and widely-used exam method, applied in

The Babinski Sign

By Michael Vogel Among the key players in the neurological revolution of the early 19th Century, few may claim as much lasting relevance as Jean-Martin Charcot. Lending his eponym to phenomena such as Charcot’s Joint (diabetic arthropathy), Charcot’s Triad (acute cholangitis) and most notably Charcot’s Disease (ALS), the French physician is widely considered to be

On Chekhov: The Marriage of Medicine and Literature

By Damiana Andonova Anton Chekhov, Russian physician-playwright from Tagranog, must have written about more than a hundred physician characters in his literary career. They’ve appeared in plays from Platonov to The Three Sisters and many short stories. Each character is unique, variable in personality, in medical attitude, and method. What caricatures: the pompous speaker, the

The History of Pulsus Paradoxus

Given our recent post and Stanford 25 session on pulsus paradoxus, we wanted to continue the theme with a historical perspective: According to this article, cardiac tamponade was first noted by the Cornish physician Richard Lower in the following quote: “The envelope becomes filled in hydrops of the heart; the walls of the heart are

The History of the Reflex Hammer

Did you know the first hammers weren’t used for reflexes? They were initially used for percussion. The first hammer used for percussion was created by a Scottish physician Sir David Barry in the early 1800’s. In 1870, Wilhelm Heinrich Erb recognized the diagnostic use of the percussion hammer in the patellar (or knee-erk) reflex. Together