[Physiological changes of organs in old age]. / Altersphysiologische Veränderungen der Organe.

The disease of old age considerably differs from the disease in adults. This is based on a decreased function of the organ systems caused by old age and on the multimorbidity which can regularly be proved at older age. The therapeutic peculiarities consist in the fact that the measures of rehabilitation become more and more difficult with growing age and that the effect of medicaments has changed by alterations of the water and fat content as well as of the cardiovascular system and the respiration caused by old age. By the mental restriction a deterioration of the observance rate of prescriptions of medicaments develops. Above all at old age there is often a gross discrepancy between the objectively recognizable findings and the complaints. Adaptability to the external conditions of a disease lead to the notion of the "conditioned health" also at old age.

[The step toward a specific diagnosis. Evaluation of the value of diagnostic methods in the individual case with special attention to probability]. / Der Schritt zur gezielten Diagnostik. Abklärung des Wertes diagnostischer Methoden im Einzelfall unter Berücksichtigung von Wahrscheinlichkeiten.

The preliminary diagnosis based on the patient's history and the results of a physical examination, is considered to be the most probable one. In general, however, differential diagnoses with a smaller degree of probability must also be taken into account. This article shows how--making use of simple probability theory--an assessment can be made as to whether an available diagnostic instrument is capable of increasing the probability of a post-test diagnosis vis-a-vis the pre-test probability level. The terms sensitivity and specificity are explained with the aid of clinical examples, and the possibility of increasing the probability of the diagnosis by iteration is discussed.

[Syncope. An important border-line between neurology and internal medicine (author's transl)]. / Der synkopale Anfall. Ein wesentliches Grenzgebiet zwischen Neurologie und Innerer Medizin.

It is important for the neurologist to know the variations of the Adams-Stokes's attack so that the important differential diagnosis between an epileptic reaction and an Adams-Stokes's attack due to cardiac rhythmic disorder can be made. The Adams-Stokes's syndrome is not only due to asystoles in the sense of cardiac arrest but also to ventricular fibrillation and especially to the very common syndrome of the pathological sinoauricular node. The great importance of digitalis overdose is pointed out as an eliciting factor for the kind of arrhythmia which runs a course similar to that of the Adams-Stokes's syndrome.