TREATMENT OF LYMPHOEDEMA BY PLASTIC OPERATION

Case 2.-An elderly, stout, stocky, emphysematous man, aged 68, complained of breathlessness on exertion, which his family attributed to increasing laziness, and urged exercise " to work off his fat." No impulse could be felt, no outline percussed, nor was there other evidence of disease. I did not think that the heart was enlarged, but a skiagram showed marked general enlargement, while the electrocardiogram had inverted 'F waves in Lead 1, accompanied by left ventricular preponderance. This case is easy to understand, but I know of no satisfactory explanation of the conducted impulse which is the common source of error.