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He made an uninterrupted recovery and was discharged from Hospital on August 30th quite free from cough, liver dulness normal. Stools formed, and able to eat anything.
CASE OF ALCOHOLISM FOLLOWED BY HYPERPYREXIA.-COMA, DEATH.
F. G., age 50, marine engineer of Scotch nationality, was admitted suffer- ring from alcoholism. According to the history of the case given by his friends who brought him, patient had for many years been a steady drinker, but went to excess during the previous week. A few hours before admission patient tried to jump out of a second storey window, hence the anxiety of his friends to put him under restraint.
When admitted patient was in the usual maudlin-argumentative state of a chronic drinker who had taken too much, but not enough to send him to sleep. In appearance he was a short, stout, thick set man with florid flushed face and short neck. He talked fairly rational, knew where he was, and though disposed to be violent was amenable to firmness and reason. He stated he wanted a good sleep as he had not slept for many nights. His pulse was 86, and his temperature 100 F., after a glass of milk and soda water (as he was thirsty), and a sedative draught patient went to sleep. He had a good night, slept 6 hours, and at 5.30 a.m. draught was repeated, he then slept until 8 a.m. He stated he felt quite well, temp 101-4° F., pulse 88, a diaphoretic mixture was ordered every 4 hours, and milk, soda-water, chicken broth, etc., besides the ordinary low diet, which includes beef-tea.
At 7.30 p.m. temperature rose to 103 F., notes read "patient comfortable, takes his food, talks quite rational and feels better. States his resolve to stay in Hospital for at least a week, or until he is quite cured."
At 9.30 p.m. temperature was 103-4°. Phenacetine gr. ii and caffeine gr. iv given in powder, ice-bag applied to the head; the powder was vomited.
His temperature steadily rose and at 10.10 p.m. reached 105-6° F. Cold sponging was started, ice-bag to head continued and ice and milk and soda given at intervals to allay thirst, patient grumbled at being cold sponged, talked rationally at times but sufferred from delusions.
10.40 p.m. temperature reduced to 103° F. Cold sponging stopped. 11 p.m. a loose brown watery motion was passed. 11.10 p.m. Temperature rose suddenly to 105.6°, pulse 114, thready, patient incoherent. Cold sponging re-started 11.50 p.m. Temperature 102° F., Inj. Strych. Hypo grains x. given Brandy fi and water given at intervals of ten minutes. 12.10 a.m. Temperature 104.8° Cold sponging re-started. 12.40 a.m. Temperature 109° F., bowels open, motion loose, offensive, and brown colour. 12.50 a.m. Temperature 110° F. taken at axilla and rectum, and remained 110° F., in spite of every effort to reduce it. Patient was wrapped in sheets wrung out of ice water, and sheets in position rubbed with lump ice. Patient kept quite unconscious from 12.10 a.m., with noisy respiration, pulse 150, racing, till 1.55 a.m. when he died. Temperature registered 110° F. in axilla and rectum just before death, and in rectum five minutes after death.
TREATMENT OF PHTHISIS BY UREA.
:
Phthisis. The treatment of this disease by urea, as suggested by Dr. HARPER in the Lancet of 1901, was tried in several cases, but the results were disappointing and as far as we are concerned this drug must be added to the already large list of drugs reputed to be cures but failing to hold their reputation. How Dr. HARPER obtained such excellent results is a mystery. The drug was only used in cases in which tubercle bacilli were found in the sputum. The dose was from fifteen grains up to thirty grains thrice daily. In not a single case (save one perhaps) was any decided benefit noticed.
The tubercle bacilli disappeared in some cases at first, and in others no effect was noticed, whilst in others they reappeared after a time though the patient was still taking the drug. It had no appreciable influence on the weight.
Of the ten cases in which it was tried, three died in Hospital.
In one case (Dr. Lowson's) after 6 weeks in Hospital, twenty grains of urea
were given and increased to thirty grains three times a day.
This patient was very ill and was aspirated several times, he had all and every attention in diet, &c., his weight went from 9.1 to 10.5 stones and the tubercle bacilli disappeared almost completely, this is the one exception referred to.