DIAGNOSIS OF HEMORRHAGIC DISEASES—Evaluation of Procedures

Careful and complete history and physical examination are essential in the diagnosis of diseases characterized by hemorrhage and are more reliable than laboratory tests for the prediction of the tendency to bleed at the time of surgical operation. Specific questions should be asked about bleeding from various anatomical sites, allergic manifestations, diet, and exposure to poisons and chemical substances. Because hemorrhagic diseases may be hereditary, it is necessary to obtain a family history. If there is a personal or family history of abnormal bleeding, the examiner should obtain exact details about the events immediately preceding the bleeding episodes, the character and duration of the hemorrhage and the response to therapy.The history is particularly important in the case of patients who are to have operation. Failure to obtain a history of past bleeding episodes may be catastrophic. In patients with bleeding tendencies who require operation, the history is valuable in predicting the severity of the bleeding.Physical examination including examination of retina, breast and pelvic organs will often detect evidence of lesions that are helpful in the diagnosis of the primary diseases of which the hemorrhage is a manifestation. The location, distribution, character and number of hemorrhagic lesions are of value in diagnosis and in prognosis.     

On Pseudoaraucaria Fliche emend., a Genus of Fossil Pinaceous Cones

The type material of some fossil Pinaceous cones (from the Albianof France) originally described by Fliche in 1896 under thename Pseudoaraucaria is here redescribed in detail. The conesare similar in form to one from the English Lower Greensandhitherto called Pityostrobus benstedi (Mantell) Seward whichis also redescribed here. This newly recognized group of conesdiffers from the cones of any of the recent members of the Pinaceaechiefly by (a) the massive ridge of scale tissue lying betweenthe seeds so that these are deeply embedded in the basal partof the scale, and (b) the presence of a cushion of parenchymaat the chalazal end of the seed. The probable significance ofthese and certain other characters is discussed.     

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